Individual
DENNIS W IVILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1501 LANSDOWNE AVE STE 303, DARBY, PA 19023-1333
(215) 334-3869
(215) 755-3300
Mailing address
804 SOUTH AVE APT D8, SECANE, PA 19018-4426
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
25MA07886000
NJ
208100000X
Physical Medicine & Rehabilitation Physician
Primary
MD042916L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0119006000
IBC
PA
01
—
0425300
CIGNA
—
01
—
3740103
AETNA
PA
Enumeration date
05/19/2006
Last updated
08/13/2014
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