MRS. SUSAN R. ILLIKMAN (NPI# 1245237387) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245237387 |
| Entity Type | Individual |
| Full Name | MRS. SUSAN R. ILLIKMAN |
| Credential | N.P. |
| Practice Address |
5325 Elliott Dr Ypsilanti MI 48197-8633 |
| Practice Telephone | 7347128000 |
| Practice Fax Number | 7347128010 |
| Mailing Telephone | 7347128000 |
| Mailing Fax Number | 7347128010 |
| Enumeration Date | 2005-07-05 |
| Last Update Date | 2009-01-29 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
4704199428 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | BCBS INDIVIDUAL PIN | 5008604980 | 01 |
| MI | BCBS GROUP PIN | 0E01050 | 01 |
| MI | AETNA | 7451595 | 01 |
| Street Address |
5325 ELLIOTT DR |
| City | YPSILANTI |
| State | MI |
| Zip Code | 48197-8633 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710533799 | Catherine I Giles | Nurse Practitioner | 5325 Elliott Dr, Ypsilanti, MI 48197-8633 | 2019-08-14 |
| 1083102214 | Christine Glowacki | Nurse Practitioner | 5325 Elliott Dr, Ypsilanti, MI 48197-8633 | 2018-04-24 |
| 1619488384 | Elizabeth H Stalder | Nurse Practitioner | 5325 Elliott Dr, Ypsilanti, MI 48197 | 2017-10-20 |
| 1609312420 | Terri Lynn Trombley | Registered Nurse | 5325 Elliott Dr, Ypsilanti, MI 48197-8633 | 2017-01-18 |
| 1235685041 | Diana Rego | Nurse Practitioner | 5325 Elliott Dr, Suite 104, Ypsilanti, MI 48197-8633 | 2016-08-31 |
| 1184170524 | Cristina Hauncher | Dietitian, Registered | 5325 Elliott Dr, Ypsilanti, MI 48197-8633 | 2016-08-26 |
| 1629524194 | Zachary Ryan York | Nurse Practitioner | 5325 Elliott Dr, Ypsilanti, MI 48197-8633 | 2016-08-25 |
| 1225583362 | Kathleen Ritzert | Nurse Practitioner | 5325 Elliott Dr, Ypsilanti, MI 48197-8633 | 2016-08-18 |
| 1902359094 | St Joseph Mercy Hospital | Clinic/Center | 5325 Elliott Dr, Sutie 105, Ypsilanti, MI 48197-8633 | 2016-07-26 |
| 1972959351 | Brittany Pridham | Nurse Practitioner | 5325 Elliott Dr, Ypsilanti, MI 48197-8633 | 2016-05-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700423092 | Devika Dibya Choudhuri | Counselor | 135 Porter West Circle Drive, Ypsilanti, MI 48197 | 2019-12-05 |
| 1770128837 | Brian Lee Shue | Registered Nurse | 6277 Maplehurst Dr, Ypsilanti, MI 48197 | 2019-11-13 |
| 1639721566 | Darlene E Bellers | 845 W. Circle Dr, Suite 160, Ypsilanti, MI 48197 | 2019-07-11 | |
| 1073165874 | Eastern Michigan University | Dietitian, Registered | Suite 160 Rackham, Ypsilanti, MI 48197 | 2019-07-11 |
| 1447815469 | Rainbow Rehabilitation Centers, Inc. | Community Based Residential Treatment Facility, Mental Illness | 6200 Textile Rd, Ypsilanti, MI 48197 | 2019-05-06 |
| 1417416298 | Justin Brewer | Student in an Organized Health Care Education/Training Program | 5333 Mcauley Drive Suite 2115, Ypsilanti, MI 48197 | 2019-03-19 |
| 1124519780 | Great Lakes Mindfulness LLC | Community/Behavioral Health | 4007 Carpenter Rd # 280, Ypsilanti, MI 48197 | 2018-05-19 |
| 1841799715 | Bedside Angel's Home Care, LLC | Home Health | 2032 S. Congress Street, Ypsilanti, MI 48197 | 2018-02-06 |
| 1891211777 | Brandon James Kukal | Specialist/Technologist | 799 N Hewitt, Ypslinati, MI 48197 | 2017-08-22 |
| 1669908737 | Michael Bekkerman | Student in an Organized Health Care Education/Training Program | 5303 Elliot Drive, Cancer Center, Ypsilanti, MI 48197 | 2017-05-10 |
| Find all providers in zip 48197 | ||||
| Taxonomy Code | 363LA2100X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Acute Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497221584 | Expedient Health Services LLC | Nurse Practitioner | 1606 S Huron St Unit 97019, Ypsilanti, MI 48197-9663 | 2018-10-16 |
| 1285016246 | Maria Isabel Contreras | Nurse Practitioner | 7780 Whittaker Rd, Ypsilanti, MI 48197-9774 | 2015-06-25 |
| 1073152617 | Kayla Lynne Prasch | Nurse Practitioner | 5301 Mcauley Dr, Ypsilanti, MI 48197-1051 | 2019-12-30 |
| 1982262309 | Caitlyn Rademacher | Nurse Practitioner | 5301 Mcauley Dr, Ypsilanti, MI 48197-1051 | 2019-05-31 |
| 1912491796 | Kristen Diez | Nurse Practitioner | 5305 Mcauley Dr, Ypsilanti, MI 48197-1051 | 2018-06-15 |
| 1518327451 | Martha Mcaleer | Nurse Practitioner | 5301 Mcauley Dr, Ypsilanti, MI 48197-1051 | 2016-03-04 |
| 1831554229 | Mary B Maes | Nurse Practitioner | 5301 E Huron River Dr, Suite 2199, Ypsilanti, MI 48197-1051 | 2015-12-29 |
| 1356731673 | Allison Dibrano | Nurse Practitioner | 5301 Mcauley Dr, Ypsilanti, MI 48197-1051 | 2015-01-24 |
| 1124454251 | Erica Karim Blum | Nurse Practitioner | 5301 E Huron River Dr, Ypsilanti, MI 48197-1051 | 2013-09-20 |
| 1326324435 | Johanna Elaine Thornsberry | Nurse Practitioner | 5325 Elliott Dr, Michigan Heart & Vascular Institute, Suite #102, Ypsilanti, MI 48197 | 2011-11-02 |
| Find all providers in YPSILANTI | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.