Individual
DR. KURT ROBERT ILLIG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD, LP
Contact information
Practice address
3795 PILOT KNOB RD, EAGAN, MN 55122-3176
(952) 595-5652
Mailing address
3795 PILOT KNOB RD, EAGAN, MN 55122-3176
(952) 595-5652
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
LP7058
MN
Other
Enumeration date
05/30/2024
Last updated
06/06/2024
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