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Dale Illingworth
NPI 1225658644 · on the registry since 2020 · sole proprietor
Practice
- Address
- 3621 Ribbon Dr
Indianapolis, IN 46227 - Phone
- (317) 652-6667
Registry record
- Primary taxonomy
- 372600000X
372600000X
- Licence states on file
- IN
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2020-04-26
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Indiana