Active NPI
Anthony R Illo, D.C.
- Chiropractor
- Portland, OR
National Provider Identifier
1689725442
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 1609
- Practice address
- 7340 S.W. Hunziker Road
Suite 101
Portland, OR 97223-2303 - Phone
- (503) 624-7249
- Fax
- (503) 684-4178
- NPI assigned
- Jan 16, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 1609 | OR | Primary |
Addresses
Primary practice location
7340 S.W. Hunziker Road
Suite 101
Portland, OR 97223-2303
Mailing address
7340 SW Hunziker St Ste 101
Portland, OR 97223-2303
Phone (503) 624-7249
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1609 | OR | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168905600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1199750400000",
"number": "1689725442",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7340 SW HUNZIKER ST STE 101",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972232303",
"telephone_number": "503-624-7249",
"fax_number": "503-684-4178"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7340 S.W. HUNZIKER ROAD",
"address_2": "SUITE 101",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972232303",
"telephone_number": "503-624-7249",
"fax_number": "503-684-4178"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ILLO",
"first_name": "ANTHONY",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-16",
"last_updated": "2008-01-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "OR",
"license": "1609",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.