Mr. Christopher G Ilacqua, MD
Physical Medicine & Rehabilitation in Southbridge, Massachusetts
1528291127- Practice location
- 100 South St, Southbridge, MA 01550-4051
- Phone
- 508-909-8590
- Fax
- 508-909-8589
- Last updated
- April 15, 2024
Christopher Glen Ilacqua is a Physical Medicine & Rehabilitation based in Southbridge, MA. Christopher Glen Ilacqua practices in Southbridge, MA and has the professional credentials of MD. The NPI Number for Christopher Glen Ilacqua is 1528291127 and holds a License No. 2015 (MA). The current practice location address for Christopher Glen Ilacqua is 100 South St, Southbridge, MA 01550-4051 and can be reached out via phone at 508-909-8590 and via fax at 508-909-8589.
Provider Profile Details
- NPI Number
- 1528291127
- Provider Name
- Christopher Glen Ilacqua
- Credential
- MD
- Provider Entity Type
- Individual
- Gender
- Male
- Address
- 100 South St, Southbridge, MA 01550-4051
- Phone Number
- 508-909-8590
- Fax Number
- 508-909-8589
- Primary Taxonomy
- Physical Medicine & Rehabilitation · 208100000X
- Sole Proprietor
- No
- Provider Enumeration Date
- August 29, 2009
- Last Update Date
- April 15, 2024
- Certification Date
- April 15, 2024
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 100 South St
Southbridge, MA 01550-4051 - City
- Southbridge
- State
- Massachusetts
- Zip
- 01550-4051
- Phone Number
- 508-909-8590
- Fax Number
- 508-909-8589
Provider Business Mailing Address Details
- Address
- Po Box 415348
Boston, MA 02241-5348 - City
- Boston
- State
- MA
- Zip
- 02241-5348
License Information
- License Number (1)
- 2015
- License State (1)
- MA
- Taxonomy (1)
- Specialist/Technologist, Athletic Trainer · 2255A2300X
- License Number (2)
- MD467051
- License State (2)
- PA
- Taxonomy (2)
- Physical Medicine & Rehabilitation · 208100000X
- License Number (3)
- 1017464
- License State (3)
- MA
- Taxonomy (3)
- Physical Medicine & Rehabilitation · 208100000X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Mr. Christopher G Ilacqua, MD?
The NPI number of Mr. Christopher G Ilacqua, MD is 1528291127. It was assigned on August 29, 2009 and is currently active in the NPPES registry.
What is the specialty of Mr. Christopher G Ilacqua, MD?
Mr. Christopher G Ilacqua, MD is registered under the primary taxonomy Physical Medicine & Rehabilitation (code 208100000X), licensed in MA under license number 2015.
Where does Mr. Christopher G Ilacqua, MD practice?
The practice location is 100 South St, Southbridge, MA 01550-4051. The office can be reached at 508-909-8590 (phone) or 508-909-8589 (fax).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1528291127 directly on the NPPES registry website.