Provider Demographics
NPI:1104094689
Name:ILO, DAVID U (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:U
Last Name:ILO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:327 E WAYNE ST STE 150
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46802-2720
Mailing Address - Country:US
Mailing Address - Phone:260-420-2800
Mailing Address - Fax:888-251-0972
Practice Address - Street 1:327 E WAYNE ST STE 150
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46802-2720
Practice Address - Country:US
Practice Address - Phone:260-420-2800
Practice Address - Fax:888-251-0972
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-18
Last Update Date:2025-01-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN01064700A207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine