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Individual
DR. STEPHEN J ILLIG
Active
Individual
DR. STEPHEN J ILLIG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
030190
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
007016271
WNYBCBS
NY
05
—
00807727
—
NY
01
—
143435
UNITED CONCORDIA
—
01
—
4001458
INDEPENDENT HEALTH
NY
Enumeration date
10/03/2006
Last updated
04/21/2025
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