Individual provider · Type 1 NPI

Stephanie Lynn Illian, PA-C

Surgical Physician Assistant · Commerce Township, MI

NPI number 1285991356 Active

Practice location

1 William Carls Dr, Ste 120
Commerce Township, MI 48382-2201

Call (248) 937-4947 Map

Mailing address

16208 Baldwin Cir
Holly, MI 48442-9384

Specialties and licenses

TaxonomyCodeLicense
Surgical Physician Assistant Primary 363AS0400X5601006316 (MI)

Surgical Physician Assistant: Definition to come...

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About NPI 1285991356

Stephanie Lynn Illian, PA-C's National Provider Identifier is 1285991356, issued on Apr 13, 2012. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Commerce Township, MI. The record was last updated on Apr 13, 2012.