Luise Ann Illuminati, M.D.

Primary specialty

Infectious Disease PhysicianTaxonomy code 207RI0200X

License

4301047490 Issued in MI

Practice address

3924 Shellmarr LN
Bloomfield Hills, MI 48302-4055

Phone

(248) 496-2112

NPI assigned

Aug 25, 2006

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573948800000",
    "number": "1912014689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3924 SHELLMARR LN",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483024055",
            "telephone_number": "248-496-2112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3924 SHELLMARR LN",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483024055",
            "telephone_number": "248-496-2112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ILLUMINATI",
        "first_name": "LUISE",
        "middle_name": "ANN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-25",
        "last_updated": "2019-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "MI",
            "license": "4301047490",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Infectious Disease Physician in Bloomfield Hills, MI
• Providers in Bloomfield Hills, MI by specialty
• Infectious Disease Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.