Brody David Ilstrup is a student in an organized health care education training program in Kenosha, WI. The provider is an individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. Brody David Ilstrup NPI is 1578129102. The provider is registered as an individual entity type.
The NPPES NPI record indicates the provider is a male.
The provider's business location address is:
2001 ALFORD PARK DR
KENOSHA, WI
ZIP 53140-927
Phone: (612) 865-8656
The enumeration date for this NPI number is 5/20/2019 and was last updated on 5/20/2019.