Provider Demographics
NPI:1659876308
Name:ILYAS, MUNEEB AKBAR (DO)
Entity type:Individual
Prefix:DR
First Name:MUNEEB
Middle Name:AKBAR
Last Name:ILYAS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2000 AUBURN DR.
Mailing Address - Street 2:STE. 350
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-4327
Mailing Address - Country:US
Mailing Address - Phone:440-646-1600
Mailing Address - Fax:440-646-1505
Practice Address - Street 1:6820 RIDGE ROAD
Practice Address - Street 2:SUITE #204
Practice Address - City:PARMA
Practice Address - State:OH
Practice Address - Zip Code:44129-5647
Practice Address - Country:US
Practice Address - Phone:440-845-1146
Practice Address - Fax:440-845-4023
Is Sole Proprietor?:No
Enumeration Date:2018-03-26
Last Update Date:2025-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0102207757207N00000X
OH34.017077207N00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0054733Medicaid