Patricio Luis Ilada IV, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

35992 Issued in WI

Practice address

5114 N Glen Park Place Rd
Peoria, IL 61614-4686

Phone

(309) 683-6600

Fax

(309) 683-2412

NPI assigned

Jan 3, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI, IL2 enrollments

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 2

Specialty

Family PracticeAlso: Hospitalist

Education

Other, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Froedtert Andthe Medical College of Wisconsin Community Physicians IncGroup PAC ID 3678760063, 1,265 clinicians

Vituity-Wisconsin HM SCGroup PAC ID 4880056126, 29 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Froedtert South Inc. Hospital, Kenosha, WI, CCN 520021

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: piladamd198130@direct.froedtert.com

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.

• Froedtert &the Medical College of Wisconsin Community Physicians, Inc.

  • Internal Medicine Physician
  • Menomonee Falls, WI
  • NPI 1568787448
  Medicare reassignment Care Compare group NPD
• Vituity-Wisconsin HM SC

  • Hospitalist Physician
  • Pleasant Prairie, WI
  • NPI 1679265912
  Medicare reassignment Care Compare group NPD
• 24 On Physicians, PC

  • Hospitalist Physician
  • Ottawa, IL
  • NPI 1346480431
  Medicare reassignment NPD
• Rockford Health Physicians

  • Multi-Specialty Clinic/Center
  • Rockford, IL
  • NPI 1043242886
  Medicare reassignment NPD
• Aspirus Rhinelander & Tomahawk Hospitals & Clinics, Inc.

  • Clinic/Center
  • Stevens Point, WI
  • NPI 1144991340
  Medicare reassignment NPD
• Mercy Health System Corporation

  • Multi-Specialty Clinic/Center
  • Janesville, WI
  • NPI 1598718603

  IL

  Medicare reassignment NPD
• Family Care Associates, Inc.

  • Family Medicine Physician
  • Racine, WI
  • NPI 1043474315
  NPD (past) Authorized official
• 24 On Physicians, P.C.

  • Hospitalist Physician
  • Attleboro, MA
  • NPI 1790104511
  NPD
• Aspirus Rhinelander & Tomahawk Hospitals & Clinics, Inc.

  • General Acute Care Hospital
  • Rhinelander, WI
  • NPI 1356391247
  NPD
• Froedtert &the Medical College of Wisconsin Community Physicians, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Wauwatosa, WI
  • NPI 1154947224
  NPD
• Mercy Health System Corporation

  • General Acute Care Hospital
  • Janesville, WI
  • NPI 1093768962
  NPD
• Mercy Health System Corporation

  • Critical Access Hospital
  • Lake Geneva, WI
  • NPI 1699728550
  NPD

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

• Froedtert South, Inc.

  • General Acute Care Hospital
  • Pleasant Prairie, WI
  • NPI 1003831132
  Care Compare affiliation

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337731200000",
    "number": "1679630156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5114 N GLEN PARK PLACE RD",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616144686",
            "telephone_number": "309-683-6600",
            "fax_number": "309-683-2412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5114 N GLEN PARK PLACE RD",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616144686",
            "telephone_number": "309-683-6600",
            "fax_number": "309-683-2412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ILADA",
        "first_name": "PATRICIO",
        "middle_name": "LUIS",
        "name_prefix": "Dr.",
        "name_suffix": "IV",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-03",
        "last_updated": "2012-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "35992",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32089400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sarah E Hyde, AU.D.
• I2 Health Opco LLC
• Riffat Iftekhar, M.D.
• Evanne M Ihnken, PA-C
• Ossama Ikladios, MD
• Sadia Ilahi, MD
• Shams B Ilahi, MD
• Tahir Ilahi, MD
• Illinois Alcohol and Drug Evaluation Service, Inc
• Illinois Cardiac Surgery Associates SC

• Family Medicine Physician in Peoria, IL
• Providers in Peoria, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2012; 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.