Individual provider Active NPI

Phoebe Iloanya

  • Physician Assistant
  • Princess Anne, MD
National Provider Identifier
1619795051
Registry record updated Sep 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
11868 College Backbone Rd
Princess Anne, MD 21853
Phone
(410) 651-2200
NPI assigned
Oct 2, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

11868 College Backbone Rd
Princess Anne, MD 21853

Mailing address

11868 College Backbone Rd
Princess Anne, MD 21853

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260206002355 IL Practitioner - Physician Assistant 6709365083 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Maryland School of Medicine, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Illinois Urgent Care Professionals PLLCGroup PAC ID 9830437946, 36 clinicians

Practice addresses (Care Compare)

17960 Halsted St
Homewood, IL 60430-2014
Phone (708) 922-0911

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Illinois Urgent Care Professionals PLLC CurrentSince Jan 13, 2026 Accepting new patients
Signify Health Medical Associates, PLLC CurrentSince Jan 11, 2026 Accepting new patients
Community Health Providers PLLC PastSince Jan 13, 2026 Accepting new patients

Locations

10834B S Doty Ave
Chicago, IL 60628
Phone (773) 995-9911

7444 W Wilson Ave
Ste 102
Harwood Hts, IL 60706
Phone 2249996997101

17960 Halsted St
Homewood, IL 60430
Phone (708) 923-0911

4055 Valley View Ln
Ste 700
Dallas, TX 75244
Phone (469) 466-7424

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1727827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758844800000",
    "number": "1619795051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11868 COLLEGE BACKBONE RD",
            "city": "PRINCESS ANNE",
            "state": "MD",
            "postal_code": "21853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11868 COLLEGE BACKBONE RD",
            "city": "PRINCESS ANNE",
            "state": "MD",
            "postal_code": "21853",
            "telephone_number": "410-651-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ILOANYA",
        "first_name": "PHOEBE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-02",
        "last_updated": "2025-09-26",
        "certification_date": "2025-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Princess Anne, MD

Sources for this page

Verify at the official NPI Registry.