Individual
LUISE ANN ILLUMINATI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3924 SHELLMARR LN, BLOOMFIELD HILLS, MI 48302-4055
(248) 496-2112
Mailing address
3924 SHELLMARR LN, BLOOMFIELD HILLS, MI 48302-4055
(248) 496-2112
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
4301047490
MI
Other
Enumeration date
08/25/2006
Last updated
11/17/2019
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