Active NPI
Chaylen K.K. Ilac, LMT
- Massage Therapist
- Aiea, HI
National Provider Identifier
1336410554
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MAT-11005
- Practice address
- 98-027 Hekaha St Ste 3
Aiea, HI 96701-4919 - Phone
- (808) 282-2650
- NPI assigned
- Jan 19, 2012
- Last updated
- Jan 19, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | MAT-11005 | HI | Primary |
Addresses
Primary practice location
98-027 Hekaha St Ste 3
Aiea, HI 96701-4919
Mailing address
98-027 Hekaha St Ste 3
Aiea, HI 96701-4919
Phone (808) 282-2650
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MAT-11005 | HI | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1326931200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1326931200000",
"number": "1336410554",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "98-027 HEKAHA ST STE 3",
"city": "AIEA",
"state": "HI",
"postal_code": "967014919",
"telephone_number": "808-282-2650",
"fax_number": "808-488-2221"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "98-027 HEKAHA ST STE 3",
"city": "AIEA",
"state": "HI",
"postal_code": "967014919",
"telephone_number": "808-282-2650"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ILAC",
"first_name": "CHAYLEN",
"middle_name": "K.K.",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-01-19",
"last_updated": "2012-01-19",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "HI",
"license": "MAT-11005",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Aiea, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.