Individual provider Active NPI

Michael J Ilyankoff, D.C

  • Chiropractor
  • Everett, WA
National Provider Identifier
1942224944
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH00003256 Issued in WA
Practice address
2003 132ND St SE
Suite E
Everett, WA 98208-7140
Phone
(425) 379-6301
Fax
(425) 379-5761
NPI assigned
Jul 26, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH00003256 WA Primary

Addresses

Primary practice location

2003 132ND St SE
Suite E
Everett, WA 98208-7140

Mailing address

2003 132ND St SE
Suite E
Everett, WA 98208-7140
Phone (425) 379-6301

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

LicenseStateTypeSpecialty
CH00003256WAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
First Chiropractic Corp Chiropractor CurrentSince Jul 13, 2019 Accepting new patients
Momentum Clinic Chiropractor PastSince Dec 13, 2022 Accepting new patients
Lake Stevens Chiropractic, PLLC Chiropractor PastSince Jan 2, 2007 Accepting new patients

Locations

2003 132nd St SE
Ste E
Everett, WA 98208
Phone (425) 355-1500

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": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1942224944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2003 132ND ST SE",
            "address_2": "SUITE E",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982087140",
            "telephone_number": "425-379-6301",
            "fax_number": "425-379-5761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2003 132ND ST SE",
            "address_2": "SUITE E",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982087140",
            "telephone_number": "425-379-6301",
            "fax_number": "425-379-5761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ILYANKOFF",
        "first_name": "MICHAEL",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00003256",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.