Healthcare Provider Details

I. General information

NPI: 1245586627
Provider Name (Legal Business Name): INNA DILMAN PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2012
Last Update Date: 08/01/2024
Certification Date: 08/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4711 GOLF RD STE 1200
SKOKIE IL
60076-1200
US

IV. Provider business mailing address

23143 N SANCTUARY CLUB DR
KILDEER IL
60047-8615
US

V. Phone/Fax

Practice location:
  • Phone: 224-217-9019
  • Fax:
Mailing address:
  • Phone: 847-682-4998
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number085.004494
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: