Ilko Family Medicine PA

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

ILKO FAMILY MEDICINE PA

Practice address

1687 Woodlane Dr
Suite 102
Woodbury, MN 55125-3045

Phone

(651) 209-6685

Fax

(651) 209-1680

NPI assigned

Jul 7, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Lisa Ryan

Title

Manager

Phone

(815) 834-7200

Specialties & licenses 1

Addresses

Other identifiers 1

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/9801/brand/1/csg/1/fhir/r4

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Todd A Leonard, MD

  • Family Medicine Physician
  • Sartell, MN
  • NPI 1740221829

  Family Medicine

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1215388800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1233532800000",
    "number": "1124281571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25530",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551250530",
            "telephone_number": "651-209-6685",
            "fax_number": "651-209-1680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1687 WOODLANE DR",
            "address_2": "SUITE 102",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551253045",
            "telephone_number": "651-209-6685",
            "fax_number": "651-209-1680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ILKO FAMILY MEDICINE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-07",
        "last_updated": "2009-02-02",
        "status": "A",
        "authorized_official_last_name": "RYAN",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "815-834-7200"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR",
            "identifier": "CJ9584",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ryan Kimlong Huynh, MD
• Jasmine Dawn Hynes
• Hyatt M Ibrahim
• Ideal Perception Mental Health Services LLC
• Amber Darlene Ignaszewski, PA
• James Ilko, M.D.
• Georgia Rae Illa
• Jarryd Patrick Imoto, DC
• Impact Psychology PLLC
• Infertility Lab and Surgery Center

• All providers in Woodbury, MN
• Family Medicine Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.