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General NPI Number Information
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NPI Number | 1023001815
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Entity Type | Organization
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Legal Business Name | ILBNC, P.A.
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Dates
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Enumeration Date | 08/26/2005
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Last Update Date | 01/02/2015
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Provider Practice Location Address
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Address Line | 3001 METRO DR SUITE 330
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City | BLOOMINGTON
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State | MN
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Zip | 55425-4506
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Country | US
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Telephone | 952-814-6600
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Fax | 952-814-6700
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Provider Business Mailing Address
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Address Line | 3001 METRO DR SUITE 330
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City | BLOOMINGTON
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State | MN
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Zip | 55425-4506
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Country | US
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Telephone | 952-814-6600
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Fax | 952-814-6700
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Authorized Official
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Title or Position | CLINIC OPERATIONS MANAGER
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Name | NICOLE MARIE HILGARDNER
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Credential |
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Telephone | 952-814-6600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XS0117X
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Taxonomy Name | Orthopaedic Surgery of the Spine Physician
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License Number |
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License Number State | MN
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