Shane Iljana

NPI #1194510289 in Fargo, North Dakota

Provider Information

NPI Number: 1194510289
Entity Type: Individual
Name: Shane Iljana
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Technician
Enumeration Date: Apr 10, 2025
Last Updated: Apr 10, 2025

Practice Location

Address: PO BOX 11394
City: Fargo
State: North Dakota
ZIP Code: 58106-1394
Phone: (218) 940-2331

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Technician	374700000X	Primary

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