Annika S Illum, M.D.

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

P1086 Issued in TX

Practice address

17101 Preston Rd Ste 190-S
Dallas, TX 75248-1331

Phone

(214) 377-7576

Fax

(214) 377-7690

NPI assigned

May 29, 2007

Last updated

Jul 21, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Dr. Annika Sandra Illum Professional name

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Cardiovascular Disease (Cardiology)Also: Internal Medicine

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baylor Scott & White the Heart Hospital Plano Hospital, Plano, TX, CCN 670025
• Texas Health Presbyterian Hospital Plano Hospital, Plano, TX, CCN 450771

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/IEFJAD/Endpoint/IEFJAD

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

• Sandra Illum MD PLLC

  dba Advanced Heart and Vascular Center

  • Cardiovascular Disease Physician
  • Dallas, TX
  • NPI 1144761404
  Medicare reassignment NPD Authorized official
• Health Imaging Partners, LLC

  dba Envision Imaging of DeSoto

  • Physiological Laboratory
  • Dallas, TX
  • NPI 1275892341
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Texas Health Presbyterian Hospital Plano

  • General Acute Care Hospital
  • Plano, TX
  • NPI 1770514077
  Care Compare affiliation
• Texas Heart Hospital of the Southwest, LLC

  dba Baylor Scott & White the Heart Hospital - Plano

  • General Acute Care Hospital
  • Plano, TX
  • NPI 1962504340
  Care Compare affiliation

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

{
    "created_epoch": "1180396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1588865778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17101 PRESTON RD STE 190-S",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752481331",
            "telephone_number": "214-377-7576",
            "fax_number": "214-377-7690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17101 PRESTON RD STE 190-S",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752481331",
            "telephone_number": "214-377-7576",
            "fax_number": "214-377-7690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ILLUM",
        "first_name": "ANNIKA",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-29",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "LA",
            "license": "MD.200464",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "TX",
            "license": "P1086",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "00U3Z7",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANNIKA",
            "last_name": "ILLUM",
            "middle_name": "SANDRA",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Angela Le Iledan, CRNA
• Jasper O Ileka, PD
• Molly Iler, LPC
• Charles Alfred Iliya, M.D.
• Illee Healthcare Services LLC
• Illumin8 Chiropractic East Dallas
• Illuminated Direction LLC
• Illuminated Hope Counseling & Consulting, PLLC
• Amarachi Ilokwu, PHARMD
• Ijeudo Ilokwu, DDS

• Cardiovascular Disease Physician in Dallas, TX
• Providers in Dallas, TX by specialty
• Cardiovascular Disease Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.