MRS. MELISSA M ILG (NPI# 1225083371) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225083371 |
| Entity Type | Individual |
| Full Name | MRS. MELISSA M ILG |
| Credential | N.P. |
| Practice Address |
921 N Lake Shore Dr Culver IN 46511-1207 |
| Mailing Address |
707 E Cedar St Ste 200 South Bend IN 46617-2057 |
| Practice Telephone | 5743357780 |
| Practice Fax Number | 5743350730 |
| Mailing Telephone | 5743358700 |
| Mailing Fax Number | 5743350760 |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2016-09-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | 71005407B | IN | Allopathic & Osteopathic Physicians |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
71005407A | IN | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
209005803 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 201284330 | 05 | |
| IN | BCBS LSC | 000000924950 | 01 |
| IN | BCBS SJHC | 000000928256 | 01 |
| IN | BCBS PFIM | 000000928877 | 01 |
| IN | BCBS MCFP | 000000928643 | 01 |
| Street Address |
921 N LAKE SHORE DR |
| City | CULVER |
| State | IN |
| Zip Code | 46511-1207 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306814413 | Michael F Deery | Family Medicine | 921 N Lake Shore Dr, Culver, IN 46511 | 2006-03-14 |
| 1366566424 | Lake Shore Clinic | Clinic/Center | 921 N Lake Shore Dr, Culver, IN 46511-1207 | 2007-03-16 |
| 1730274556 | Noemi Adame | Pediatrics | 921 N Lake Shore Dr, Culver, IN 46511-1207 | 2006-10-04 |
| 1235245002 | Rebecca M Brice | Family Medicine | 921 N Lake Shore Dr, Culver, IN 46511-1207 | 2006-08-22 |
| 1467404640 | Warren K Reiss | Family Medicine | 921 N Lake Shore Dr, Culver, IN 46511-1207 | 2006-05-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437309838 | Kristine Marie Weaver | Nurse Practitioner | 232 S Main St Ste A, Culver, IN 46511 | 2008-09-23 |
| 1649361031 | John R. Bernero | Internal Medicine | 1680 E. Shore Dr., Culver, IN 46511 | 2006-09-28 |
| 1427595842 | Mackenzie Davenport | Specialist/Technologist | 1300 Academy Rd, Culver, IN 46511 | 2017-01-24 |
| 1033624499 | Stephanie Stichter | Specialist/Technologist | 701 School St, Culver, IN 46511-1026 | 2017-12-07 |
| 1104155415 | Culver Community Schools | Local Education Agency (LEA) | 700 School St, Culver, IN 46511-1027 | 2009-12-15 |
| 1770504813 | Johnson Memorial Hospital | Durable Medical Equipment & Medical Supplies | 730 School St, Culver, IN 46511-1027 | 2006-07-22 |
| 1679970644 | Culver Comm Sch Corp | Point of Service | 700 School St, Culver, IN 46511-1027 | 2014-11-19 |
| 1184672032 | Kurt Nathan Richeson | Dentist | 1001 N Lake Shore Dr, Culver, IN 46511-1209 | 2006-05-04 |
| 1891037164 | Ourhealth Physician Group, LLC | Clinic/Center | 121 N Terrace Dr, Culver, IN 46511-1222 | 2013-03-25 |
| 1982199014 | Brian Rosenau | Specialist/Technologist | 1300 Academy Rd # 95, Culver, IN 46511-1234 | 2018-07-01 |
| Find all providers in zip 46511 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437309838 | Kristine Marie Weaver | Nurse Practitioner | 232 S Main St Ste A, Culver, IN 46511 | 2008-09-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386244176 | Mallory Lee Anslow | Nurse Practitioner | 10641 Deercrest Ln, Indianapolis, IN 46239-9690 | 2020-10-29 |
| 1285234237 | Vb Medical Group LLC | Nurse Practitioner | 10047 Whispering Wind Dr, Greenville, IN 47124-9704 | 2020-10-29 |
| 1518566397 | Stacey Renee Pulver | Nurse Practitioner | 13134 Hollow Oak Rd, Fort Wayne, IN 46845-2327 | 2020-10-22 |
| 1578162459 | Kourtney Marie Terry | Nurse Practitioner | 128 Miner Rd, Avilla, IN 46710-9690 | 2020-10-21 |
| 1780283630 | Dana L Yergler | Nurse Practitioner | 16632 Linfield Ct, Granger, IN 46530-7012 | 2020-10-21 |
| 1730788720 | Camille Mae Carl | Nurse Practitioner | 6441 Anna Louise Dr, Charlestown, IN 47111-8797 | 2020-10-20 |
| 1124626585 | Dustin Mikesell | Nurse Practitioner | 1000 E Main St Ste 104, Danville, IN 46122-1948 | 2020-10-16 |
| 1144828799 | Mina Desai-patel | Nurse Practitioner | 14698 Drayton Dr, Noblesville, IN 46062-8230 | 2020-10-15 |
| 1649878554 | Heather Ormiston-leclear | Nurse Practitioner | 3800 N Anthony Blvd # Cc1335, Fort Wayne, IN 46805-1430 | 2020-10-13 |
| 1023616125 | Kimberly Dawn Calloway | Nurse Practitioner | 5306 E Blocher Rd, Lexington, IN 47138-8803 | 2020-10-12 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.