MARIANNE ILLUSTRE NPI 1679445738

NPI Information

  • NPI: 1679445738
  • Provider Name: MARIANNE ILLUSTRE
  • Classification: Physician Assistant - 363A00000X
  • Entity Type: Individual
  • Address: 14300 N 83RD AVE APT 2013
    PEORIA, AZ
    ZIP 85381
  • Phone: (516) 725-7481

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NPI Details

Marianne Illustre is a physician assistant in Peoria, AZ. The provider is a physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. Marianne Illustre NPI is 1679445738. The provider is registered as an individual entity type and is a single specialty group.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

14300 N 83RD AVE APT 2013
PEORIA, AZ
ZIP 85381-606
Phone: (516) 725-7481

The enumeration date for this NPI number is 9/19/2025 and was last updated on 9/19/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363A00000XPhysician Assistant2788PUERTO RICOYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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