Victor Lee Ilog, FNP

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

License

G-1916 Issued in NM

Practice address

6202 Alchemy St
Las Cruces, NM 88012-0850

Phone

(575) 520-2824

NPI assigned

Feb 12, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  Psychiatric/Mental Health, TX

  Medicare reassignment NPD
• Milestones LLC

  • Health & Wellness Coach
  • Las Cruces, NM
  • NPI 1659185627

  Community Health Worker

  NPD (past)
• Shape Health, LLC

  • Community Health Worker
  • Las Cruces, NM
  • NPI 1437042165
  NPD (past)

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

{
    "created_epoch": "1518393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776038400000",
    "number": "1134628563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6202 ALCHEMY ST",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880120850",
            "telephone_number": "575-520-2824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6202 ALCHEMY ST",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880120850",
            "telephone_number": "575-520-2824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ILOG",
        "first_name": "VICTOR",
        "middle_name": "LEE",
        "name_prefix": "Mr.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-02-12",
        "last_updated": "2026-04-13",
        "certification_date": "2026-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "NM",
            "license": "G-1916",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ideal Option PLLC
• Pretty Sara Idiculla, MD
• Imad A.R. Idriss, M.D.
• Maria Jose Iglesias-Corral
• Claudia Isela Iglesias
• Imad Idriss MD PA
• Mia Impastato
• Fernando J Indacochea, MD
• Indian Wells Ultrasound Imaging Inc
• Inetmed RX2 Inc.

• Community Health Worker in Las Cruces, NM
• Providers in Las Cruces, NM by specialty
• Community Health Worker in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.