DR. JOANNE MARIE ILUSTRE (NPI# 1750545661) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750545661 |
| Entity Type | Individual |
| Full Name | DR. JOANNE MARIE ILUSTRE |
| Credential | DO |
| Practice Address |
1 Bartol Ave Ste 10 Ridley Park PA 19078-2214 |
| Mailing Address |
207 N Broad St Fl 3 Philadelphia PA 19107-1500 |
| Practice Telephone | 6105210150 |
| Practice Fax Number | 6105216493 |
| Mailing Telephone | 2674794142 |
| Mailing Fax Number | 2154633820 |
| Enumeration Date | 2008-07-10 |
| Last Update Date | 2019-09-23 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
OS015002 | PA | Allopathic & Osteopathic Physicians |
| N | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
C20011444 | DE | Allopathic & Osteopathic Physicians |
| Y | 207RI0011X |
Internal Medicine Specialization: Interventional Cardiology |
OS015002 | PA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | 1035757110003 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1 Medical Centr Blvd, P O Bldg 1 - Suite 400, Upland, PA 19013 | 6108762400 | 6108764308 |
| 1088 W. Baltimore Pike, 4th Floor Suite 2400, Media, PA 190631906 | 6105652100 | 6108920626 |
| Street Address |
1 BARTOL AVE STE 10 |
| City | RIDLEY PARK |
| State | PA |
| Zip Code | 19078-2214 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952762999 | Rita Ropski | Physical Therapy Assistant | 115 Rosemont Ave, Ridley Park, PA 19078 | 2016-03-18 |
| 1063871846 | Knopf Radiology and Health Services | Clinic/Center | 634 E,chester Pike, Apt F 1, Ridley Park, PA 19078 | 2016-02-22 |
| 1932574340 | Benjamin Chartier | Physician Assistant | 105 Henderson Ave, Ridley Park, PA 19078 | 2015-12-10 |
| 1992068811 | Angel Companions of Delaware County, LLC | Home Health | 113 East Sellers Ave, Suite B, Ridley Park, PA 19078 | 2012-06-18 |
| 1023276425 | Martin Joseph Dwyer Jr. | Dentist | 212 Chester Pike West, Ridley Park, PA 19078 | 2008-06-02 |
| 1881893543 | Rhonda Lee Lagamba | Occupational Therapy Assistant | 175 Chester Pike, Ridley Park, PA 19078 | 2007-07-13 |
| 1205977592 | Leedom Fire Company No 1 | Ambulance | Darby Rd and Clymer La, Ridley Park, PA 19078 | 2007-02-09 |
| 1881758506 | Collins Chiropractic P.C. | Chiropractor | 648 A East Chester Pike, Ridley Park, PA 19078 | 2006-12-20 |
| 1164518742 | John Samuel Rizzo | Ophthalmology | 8 Morton Avenue, Suite 101, Ridley Park, PA 19078 | 2006-10-04 |
| 1972511947 | John R Callahan Dds Assoc | Dentist | 101 E Ward Ave, Ridley Park, PA 19078 | 2006-08-04 |
| Find all providers in zip 19078 | ||||
| Taxonomy Code | 207RI0011X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Interventional Cardiology |
| An area of medicine within the subspecialty of cardiology, which uses specialized imaging and other diagnostic techniques to evaluate blood flow and pressure in the coronary arteries and chambers of the heart and uses technical procedures and medications to treat abnormalities that impair the function of the cardiovascular system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/ Board Certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. ACGME Accredited Residency Program Requirements: 1 year of training plus a prerequisite of 3 years Internal Medicine, 3 years Cardiovascular Disease for a total of 7 years. ABMS Approved Subspecialty Certificate (Internal Medicine) |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326609686 | Grand View Hospital | Internal Medicine | 700 Lawn Ave Fl 2, Sellersville, PA 18960-1548 | 2019-06-26 |
| 1841798121 | Coordinated Health of Penn, LLC | Internal Medicine | 1700 Market St Ste 1005a104, Philadelphia, PA 19103-3913 | 2018-01-31 |
| 1124409826 | Sanjog Kalra | Internal Medicine | 5501 Old York Road, 3rd Floor Levy Building, Albert Einstein Medical Center-division of Cardiology, Philadelphia, PA 19141 | 2015-06-18 |
| 1588905095 | Harvard Cardiovascular Inc | Internal Medicine | 362 Sprague Rd, Penn Valley, PA 19072-1124 | 2013-03-07 |
| 1669784880 | Paul Lewis Hermany II | Internal Medicine | 2649 Schoenersville Rd Ste 301, Bethlehem, PA 18017 | 2010-07-02 |
| 1063651123 | Deepika Rao Kalisetti | Internal Medicine | 743 Jefferson Ave Ste 305, Scranton, PA 18510-1639 | 2009-02-13 |
| 1679591374 | Subrahmanyam Chivukula | Internal Medicine | 245 Mill Street, Bristol, PA 19007 | 2006-07-18 |
| 1710913736 | Stafford Michael Smith | Internal Medicine | 102 N Abington Rd, Suite #103, Clarks Green, PA 18411-2300 | 2006-06-23 |
| 1891732541 | Gregory D Cox | Internal Medicine | 2135 Noll Dr Ste D, Lancaster, PA 17603-7602 | 2006-06-01 |
| 1811934565 | Scott T. Riebel | Internal Medicine | 1600 6th Ave Ste 108, York, PA 17403-2626 | 2006-06-01 |
| Find all providers with the same taxonomy | ||||
| City | RIDLEY PARK |
| Zip Code | 19078 |
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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.