Mark Andrew Ilgen
Clinical Psychologist Cognitive & Behavioral Psychologist
4250 Plymouth Rd
Ann Arbor
, Michigan 48109-2700
Mark Andrew Ilgen
Clinical Psychologist Cognitive & Behavioral Psychologist
4250 Plymouth Rd
Ann Arbor
, Michigan 48109-2700
(734) 647-5299
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About
Features
Specialties
- Cognitive & Behavioral Psychologist
- Clinical Psychologist
Languages spoken
- English
Location
First Address
- Mark Andrew Ilgen
- 3621 S State St
- Ann Arbor, MI
- Zip : 48108-1633
- Phone : (734) 647-5299
Second Address
- Mark Andrew Ilgen
- 4250 Plymouth Rd
- Ann Arbor, MI
- Zip : 48109-2700
- Phone : (734) 764-6443
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 103TB0200X | Cognitive & Behavioral Psychologist | 6301013529 | MI |
| Y | 103G00000X | Clinical Psychologist | 6301013529 | MI |
| Y | 103TC0700X | Clinical Psychologist | 6301013529 | MI |
National Provider Identifier
| NPI | 1013043496 |
|---|---|
| Provider Name | Mark Andrew Ilgen |
| First Address | Ann Arbor, MI 48108-1633 |
| Second Address | Ann Arbor, MI 48109-2700 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 27/02/2007 |
| Last Update Date | 15/07/2020 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.