Individual
DR. JOANNE MARIE ILUSTRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1 BARTOL AVE STE 10, RIDLEY PARK, PA 19078-2214
(610) 521-0150
(610) 521-6493
Mailing address
3521 SILVERSIDE RD, STE 1C, WILMINGTON, DE 19810-4900
(267) 479-4142
(215) 463-3820
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
C20011444
DE
207RC0000X
Cardiovascular Disease Physician
Primary
OS015002
PA
207RI0011X
Interventional Cardiology Physician
OS015002
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1035757110003
—
PA
Enumeration date
07/10/2008
Last updated
01/06/2021
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us