Provider Demographics
NPI:1326395633
Name:ILIPILLA, GEETA SAI (MD)
Entity Type:Individual
Prefix:DR
First Name:GEETA
Middle Name:SAI
Last Name:ILIPILLA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:GEETA
Other - Middle Name:SAI
Other - Last Name:PILLA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:700 CHILDRENS DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43205-2664
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:700 CHILDRENS DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43205-2664
Practice Address - Country:US
Practice Address - Phone:614-355-4545
Practice Address - Fax:614-722-4575
Is Sole Proprietor?:No
Enumeration Date:2012-08-07
Last Update Date:2022-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH351311992084P0804X
OH35.1311992084P0804X
PAMT202544390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program