Basic Information
| Provider Information | |||||||||
| NPI: | 1568620599 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | NAUMANN | ||||||||
| FirstName: | ILKA | ||||||||
| MiddleName: | C | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 30055 NORTHWESTERN HWY | ||||||||
| Address2: | SUITE 101 | ||||||||
| City: | FARMINGTON HILLS | ||||||||
| State: | MI | ||||||||
| PostalCode: | 48334 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2488654444 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 30055 NORTHWESTERN HWY | ||||||||
| Address2: | SUITE 101 | ||||||||
| City: | FARMINGTON HILLS | ||||||||
| State: | MI | ||||||||
| PostalCode: | 48334 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2488654444 | ||||||||
| FaxNumber: | 2488656161 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/27/2008 | ||||||||
| LastUpdateDate: | 06/17/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/17/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Y00000X | 11012331A | IN | N | Allopathic & Osteopathic Physicians | Otolaryngology | 207YX0901X | 246091 | MA | N | Allopathic & Osteopathic Physicians | Otolaryngology | Otology & Neurotology | 207YX0901X | 4301093520 | MI | Y | Allopathic & Osteopathic Physicians | Otolaryngology | Otology & Neurotology |
No ID Information.