Individual
MR. JOHN H ILJAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
15370 LEVAN ROAD, SUITE 1, LIVONIA, MI 48154-1903
(734) 462-8401
(734) 462-1410
Mailing address
15370 LEVAN ROAD, SUITE 1, LIVONIA, MI 48154-1903
(734) 462-8401
(734) 462-1410
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
5101013457
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
340755311
—
MI
Enumeration date
03/10/2006
Last updated
11/06/2019
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