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General NPI Number Information
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NPI Number | 1346144243
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Entity Type | Individual
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Provider Name | MICHELLE ILIA
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Gender | Female
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Dates
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Enumeration Date | 10/05/2026
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Last Update Date | 10/05/2026
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Provider Practice Location Address
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Address Line | 2770 CENTENNIAL RD BLDG 7
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City | TOLEDO
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State | OH
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Zip | 43617-1829
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Country | US
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Telephone | 419-794-0567
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Fax |
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Provider Business Mailing Address
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Address Line | 5667 APPALOOSA CIR
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City | MORROW
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State | OH
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Zip | 45152-8283
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 4704398271
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | APRN.CNP.0043379
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License Number State | OH
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