DR. EMMANUEL MICHAEL ILLICAL (NPI# 1275926578) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275926578 |
| Entity Type | Individual |
| Full Name | DR. EMMANUEL MICHAEL ILLICAL |
| Credential | MD, FRCSC |
| Practice Address |
450 Clarkson Ave Brooklyn NY 11203-2012 |
| Mailing Address |
450 Clarkson Ave Box 30 Brooklyn NY 11203-2012 |
| Practice Telephone | 7182708995 |
| Practice Fax Number | 7182701309 |
| Mailing Telephone | 7182703200 |
| Mailing Fax Number | 7182702756 |
| Enumeration Date | 2015-03-10 |
| Last Update Date | 2016-04-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207X00000X | Orthopaedic Surgery | 278062-1 | NY | Allopathic & Osteopathic Physicians |
| Street Address |
450 CLARKSON AVE |
| City | BROOKLYN |
| State | NY |
| Zip Code | 11203-2012 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700888013 | David Landman | Internal Medicine | 450 Clarkson Ave, Brooklyn, NY 11203-2056 | 2005-06-01 |
| 1215537345 | Stephanie Galbert | Nurse Practitioner | 450 Clarkson Ave, Brooklyn, NY 11203-2012 | 2020-10-28 |
| 1972118560 | Juveria Ansar Peshimam | Student in an Organized Health Care Education/Training Program | 450 Clarkson Ave, Brooklyn, NY 11203-2012 | 2020-09-10 |
| 1285248831 | Khawar Nawaz | Student in an Organized Health Care Education/Training Program | 450 Clarkson Ave, Brooklyn, NY 11203-2012 | 2020-09-01 |
| 1871107458 | Sneha Naidu Gade | Student in an Organized Health Care Education/Training Program | 450 Clarkson Ave, Brooklyn, NY 11203-2012 | 2020-09-01 |
| 1063025641 | Vaibhaviben Solanki | Student in an Organized Health Care Education/Training Program | 450 Clarkson Ave, Brooklyn, NY 11203-2012 | 2020-08-25 |
| 1548873961 | Bhesh Raj Karki | Student in an Organized Health Care Education/Training Program | 450 Clarkson Ave, Brooklyn, NY 11203-2012 | 2020-08-25 |
| 1174136717 | Cyrilee Maud Thompson | Student in an Organized Health Care Education/Training Program | 450 Clarkson Ave, Brooklyn, NY 11203-2012 | 2020-08-24 |
| 1215548953 | Maximillian Anderson Weigelt | Student in an Organized Health Care Education/Training Program | 450 Clarkson Ave, Brooklyn, NY 11203-2012 | 2020-08-16 |
| 1417568106 | Kereisha Nicole Donegal | Student in an Organized Health Care Education/Training Program | 450 Clarkson Ave, Brooklyn, NY 11203-2012 | 2020-08-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023615747 | Winnie Ming Wong | Dance Therapist | 451 Clarkson Ave R Building, Idd/mh Unit, R5west, Brooklyn, NY 11203 | 2020-10-06 |
| 1174134803 | Jermiah Jonoah Jones | Social Worker | 307 E 54th St, 3, Brooklyn, NY 11203 | 2020-08-14 |
| 1780201566 | Jesvin Jeyapaulraj | Student in an Organized Health Care Education/Training Program | 450 Clarkson Avenue, Suny Downstate, General Surgery Department, Brooklyn, NY 11203 | 2020-06-29 |
| 1881219731 | Natasha Thomas | Specialist | 140 East 52nd St Brooklyn, Apt 1r, Brooklyn, NY 11203 | 2020-06-16 |
| 1679197396 | Syed Hamza Bin Waqar | Student in an Organized Health Care Education/Training Program | 450 Clarkson Avenue, Msc 50, Suny Downstate, Brooklyn, NY 11203 | 2020-05-29 |
| 1013536846 | Isaak Rubinov | Student in an Organized Health Care Education/Training Program | 91 E 39th St, Brooklyn, NY 11203 | 2020-04-12 |
| 1932733615 | Shade Celestine | Specialist | 293 East53rd Street, Brooklyn, NY 11203 | 2020-03-03 |
| 1023656147 | Shenez Brutus | Nurse Practitioner | Suny Downstate College of Nursing, 450 Clarkson Avenue, Brooklyn, NY 11203 | 2019-12-19 |
| 1215586425 | Terry-ann Lee | Registered Nurse | 440 East 45th Street, Kings, NY 11203 | 2019-09-10 |
| 1568023828 | Mmeyeneabasi David Omede | Student in an Organized Health Care Education/Training Program | 450 Clarkson Avenue, Suny Downstate Medical Center, Brooklyn, NY 11203 | 2019-06-26 |
| Find all providers in zip 11203 | ||||
| Taxonomy Code | 207X00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659819522 | W Medical Care PC | Orthopaedic Surgery | 3423 Guider Ave, Brooklyn, NY 11235-5271 | 2017-02-10 |
| 1679884613 | Raghava Rao Polavarapu,mdpc | Orthopaedic Surgery | 55 Greene Ave Ste 2c, Brooklyn, NY 11238-6432 | 2010-06-24 |
| 1114162146 | David M. Edelstein, Md, PC | Orthopaedic Surgery | 2382 East 13 Street, Brooklyn, NY 11229-4306 | 2008-12-04 |
| 1053512574 | Aditya Vikram Maheshwari | Orthopaedic Surgery | 450 Clarkson Ave Box 30, Deptt of Orthopedics, Suny Down State Medical Center, Brooklyn, NY 11203-2012 | 2007-05-31 |
| 1760537336 | Alan M Crystal | Orthopaedic Surgery | 974 52nd St, Brooklyn, NY 11219-4002 | 2007-01-24 |
| 1427100247 | Flatlands Orthopedic Medical Care, P.C. | Orthopaedic Surgery | 4526 Flatlands Ave, Brooklyn, NY 11234-3011 | 2007-01-18 |
| 1235292574 | Igor Rubinshteyn | Orthopaedic Surgery | 3049 Ocean Pkwy Fl 2, Brooklyn, NY 11235-8395 | 2006-12-18 |
| 1033287628 | Daniel W Wilen | Orthopaedic Surgery | 9202 Fort Hamilton Parkway, Brooklyn, NY 11209 | 2006-12-01 |
| 1659447399 | Jack Choueka | Orthopaedic Surgery | 6010 Bay Pkwy Fl 7, Brooklyn, NY 11204-6079 | 2006-11-27 |
| 1033219951 | Kingsway Orthopedic Professional Corporation | Orthopaedic Surgery | 3156 Kings Hwy, Brooklyn, NY 11234-2616 | 2006-09-22 |
| Find all providers in BROOKLYN | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.