Herbert Isaac Clinic PLLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

License

4301060642 Issued in MI

Legal business name

HERBERT ISAAC CLINIC PLLC

Practice address

10350 W 9 Mile Rd
Oak Park, MI 48237-2913

Phone

(248) 541-6630

NPI assigned

Sep 16, 2010

Last updated

Sep 16, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Ifey Ilechukwu, M.D

Title

Principal

Phone

(248) 541-6630

Specialties & licenses 2

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ifeyinwa Ilechukwu, MD

  • Physical Medicine & Rehabilitation Physician
  • Oak Park, MI
  • NPI 1427165109
  NPD (past)

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

{
    "created_epoch": "1284595200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1284595200000",
    "number": "1497063051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10350 W 9 MILE RD",
            "city": "OAK PARK",
            "state": "MI",
            "postal_code": "482372913",
            "telephone_number": "248-541-6630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10350 W 9 MILE RD",
            "city": "OAK PARK",
            "state": "MI",
            "postal_code": "482372913",
            "telephone_number": "248-541-6630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERBERT ISAAC CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-16",
        "last_updated": "2010-09-16",
        "status": "A",
        "authorized_official_last_name": "ILECHUKWU",
        "authorized_official_first_name": "IFEY",
        "authorized_official_title_or_position": "PRINCIPAL",
        "authorized_official_telephone_number": "248-541-6630",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "MI",
            "license": "4301060642",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "4301060642",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Clinic/Center (Including Community Mental Health Center) in Oak Park, MI
• Providers in Oak Park, MI by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 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.