Patricio a. Ilabaca, MD, PC

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

License

9582 Issued in TN

Legal business name

PATRICIO A. ILABACA, MD, PC

Practice address

6027 Walnut Grove Rd
Suite 114
Memphis, TN 38120-2145

Phone

(901) 683-6161

Fax

(901) 683-7998

NPI assigned

Sep 25, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Patricio A. Ilabaca, MDNPI 1255381406

Title

President

Phone

(901) 683-6161

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• cardiovascular & thoracic surgery Other name

Practitioners 1

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

• Patricio A Ilabaca, MD

  • Vascular Surgery Physician
  • Memphis, TN
  • NPI 1255381406
  NPD (past) Authorized official

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1287360000000",
    "number": "1386744514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6027 WALNUT GROVE RD",
            "address_2": "SUITE 114",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381202145",
            "telephone_number": "901-683-6161",
            "fax_number": "901-683-7998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6027 WALNUT GROVE RD",
            "address_2": "SUITE 114",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381202145",
            "telephone_number": "901-683-6161",
            "fax_number": "901-683-7998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATRICIO A. ILABACA, MD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-25",
        "last_updated": "2010-10-18",
        "status": "A",
        "authorized_official_last_name": "ILABACA",
        "authorized_official_first_name": "PATRICIO",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "901-683-6161",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": "TN",
            "license": "9582",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3171424",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09015252",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "cardiovascular & thoracic surgery",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Patientchoicemd, LLC
• Mahadev Patil, MD
• Elizabeth A Paton, RN,PNP,
• Miyoko Fujii Patricelli
• Patricia Chisholm, MD Primary Care
• Patrick Kolwaite
• Abigail Kurtz Patrick
• Brett Patrick, M.D.
• Joseph Patrick, MD
• Krisana Patrick

• Vascular Surgery Physician in Memphis, TN
• Providers in Memphis, TN by specialty
• Vascular Surgery Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2010; 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.