Provider Demographics
NPI:1710778584
Name:ILEVBARE, PHOEBE OSE NATALIE (MD)
Entity type:Individual
Prefix:
First Name:PHOEBE
Middle Name:OSE NATALIE
Last Name:ILEVBARE
Suffix:
Gender:F
Credentials:MD
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Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:3201 RACE ST APT 1105
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-3743
Mailing Address - Country:US
Mailing Address - Phone:646-474-1433
Mailing Address - Fax:
Practice Address - Street 1:8815 GERMANTOWN AVE FL 5
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19118-2722
Practice Address - Country:US
Practice Address - Phone:215-248-8907
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-13
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMT234120207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine