Susan R. Illikman, N.P.

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

4704199428 Issued in MI

Practice address

5325 Elliott Dr
Ypsilanti, MI 48197-8633

Phone

(734) 712-8000

Fax

(734) 712-8010

NPI assigned

Jul 5, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

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.

• Cardiovascular Institute of Michigan, P.C.

  • Cardiovascular Disease Physician
  • Roseville, MI
  • NPI 1154350890
  NPD (past)

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

{
    "created_epoch": "1120521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233187200000",
    "number": "1245237387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5325 ELLIOTT DR",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481978633",
            "telephone_number": "734-712-8000",
            "fax_number": "734-712-8010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5325 ELLIOTT DR",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481978633",
            "telephone_number": "734-712-8000",
            "fax_number": "734-712-8010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ILLIKMAN",
        "first_name": "SUSAN",
        "middle_name": "R.",
        "name_prefix": "Mrs.",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-05",
        "last_updated": "2009-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MI",
            "license": "4704199428",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP PIN",
            "identifier": "0E01050",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7451595",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS INDIVIDUAL PIN",
            "identifier": "5008604980",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Iha Health Services Organization
• Iha Health Services Organization
• Iha of Ann Arbor PC
• Iha of Ann Arbor PC
• Adam Lucas Ihrig, PA-C
• Vitalis Im
• Zainab Imami
• Christina Juliana Imlinger, MD
• Mahnoor Inamullah, M.D.
• Independent Helping Hands Service

• Acute Care Nurse Practitioner in Ypsilanti, MI
• Providers in Ypsilanti, MI by specialty
• Acute Care Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 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.