Individual
ZACHARY NICHOLAS ILLG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
303 PARKWAY DR NE, ATLANTA, GA 30312-1212
(404) 265-4000
Mailing address
2110 47TH ST, DES MOINES, IA 50310-3045
(515) 883-0464
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
5101023831
MI
207P00000X
Emergency Medicine Physician
5151013211
MI
207P00000X
Emergency Medicine Physician
Primary
88589
GA
Other
Enumeration date
03/22/2018
Last updated
04/21/2022
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