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NPI Code Detail

MEDICARE: ZANA ILIESKI

MEDICARE: ZANA ILIESKI
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11835P0018XPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist5302415167MI

General Provider Information

NPI Number : 1164296497
Entity Type Code : Individual
Provider Name (Legal Business Name) : ZANA ILIESKI
Provider Business Mailing Address
First Line : 6609 HIGHVIEW ST
Second Line :
City : DEARBORN HTS
State : MI
Zip : 48127-2159
Country : US
Telephone Number : 313-903-2965
Fax Number :
Provider Business Practice Location Address
First Line : 108 W HIGHLAND RD
Second Line :
City : HOWELL
State : MI
Zip : 48843-1159
Country : US
Telephone Number : 517-552-0205
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/07/2023
Last Update Date : 11/07/2023

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