MEDICARE: CINDY ILLIG B.A.

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
1	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1578391777
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CINDY ILLIG B.A.

Provider Business Mailing Address
First Line	:	737 BOLIVAR RD
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44115-1246
Country	:	US
Telephone Number	:	216-406-2608
Fax Number	:

Provider Business Practice Location Address
First Line	:	737 BOLIVAR RD
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44115-1246
Country	:	US
Telephone Number	:	216-406-2608
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/22/2024
Last Update Date	:	07/22/2024

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Directions to “ CINDY ILLIG B.A.” Practice Location

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