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Individual

DR. NIKHIL RAO ILLA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3400 SPRUCE STREET, GROUND SILVERSTEIN, PHILADELPHIA, PA 19104
(215) 662-6305
(215) 662-3953
Mailing address
3400 SPRUCE ST, PHILADELPHIA, PA 19104-4238
(215) 662-6305
(215) 662-3953

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD485966
PA
208D00000X
General Practice Physician
MD485966
PA

Other

Enumeration date
04/05/2022
Last updated
05/06/2026
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