Individual
DR. THOMAS LEMUEL ILUSTRISIMO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
10624 S EASTERN AVE # A-955, HENDERSON, NV 89052-2982
(702) 407-7700
(027) 407-7016
Mailing address
10624 S EASTERN AVE # A-955, HENDERSON, NV 89052-2982
(702) 407-7700
(027) 407-7016
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
DO3016
NV
207R00000X
Internal Medicine Physician
SL1459
NV
Other
Enumeration date
05/13/2019
Last updated
10/18/2022
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