BENNY ILLICKAL (NPI# 1740682673) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740682673 |
| Entity Type | Individual |
| Full Name | BENNY ILLICKAL |
| Practice Address |
291 Stone Mountain Dr Sunnyvale TX 75182-2655 |
| Practice Telephone | 9723527260 |
| Mailing Telephone | 9723527260 |
| Enumeration Date | 2014-09-23 |
| Last Update Date | 2014-09-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
R37333 | TX | Allopathic & Osteopathic Physicians |
| Street Address |
291 STONE MOUNTAIN DR |
| City | SUNNYVALE |
| State | TX |
| Zip Code | 75182-2655 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689141806 | Nia Liz Abraham | Student in an Organized Health Care Education/Training Program | 187 Mustang Dr., Sunnyvale, TX 75182 | 2018-10-25 |
| 1467969592 | Elizabeth Varghese | Nurse Practitioner | 284 Crossbow Drive, Sunnyvale, TX 75182 | 2018-01-10 |
| 1043744154 | Mini Iype | Nurse Practitioner | 360 Pedmore Dr., Sunnyvale, TX 75182 | 2017-04-14 |
| 1407389075 | Sal 2016 LLC | Assisted Living Facility | 301 T. C. Lupton Blvd, Sunnyvale, TX 75182 | 2017-04-10 |
| 1114465218 | Emanuela Berari | General Acute Care Hospital | 270 South Collins Rd, Suite 300, Sunnyvale, TX 75182 | 2017-02-08 |
| 1588019764 | Jessy Sebastian | Registered Nurse | 312 Wooded Glen Drive, Sunnyvale, TX 75182 | 2016-04-26 |
| 1982073045 | Jayaprakash Narayana Md Pa | Family Medicine | 347 Towneast Blvd, Sunnyvale, TX 75182 | 2015-09-18 |
| 1902234362 | Joychan Pariyarath Joseph | Nurse Practitioner | 514 E Tripp Rd, Sunnyvale, TX 75182 | 2013-10-23 |
| 1679834295 | North Star Mcd, LLC | Clinic/Center | 222 S Collins Road, Suite 101, Sunnyvale, TX 75182 | 2012-05-30 |
| 1760752869 | Reddy Pediatric Dentistry, P.C. | Dentist | 274 South Collins Road, Sunnyvale, TX 75182 | 2012-01-05 |
| Find all providers in zip 75182 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790018661 | Lawrence W Chan M D Inc A Professional Corporation | Radiology | 990 W Fremont Ave Ste W, Sunnyvale, CA 94087-3065 | 2009-09-10 |
| 1497924633 | Kenneth V Chong | Radiology | 1195 Queen Ann Dr, Sunnyvale, CA 94087-2240 | 2008-02-21 |
| 1821059767 | Benjamin Hong-yul Bak | Radiology | 1267 Townsend Ter, Sunnyvale, CA 94087-2065 | 2006-03-30 |
| 1477905388 | Vanguard Specialty Imaging | Radiology | 1345 Lillian Ave, Sunnyvale, CA 94087-3523 | 2016-07-05 |
| 1487963047 | Nrs Arizona Pa | Radiology | 1267 Townsend Ter, Sunnyvale, CA 94087-2065 | 2010-09-30 |
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| 1760030852 | Francis Joseph Carabin | Radiology | 318 E Nakoma St, San Antonio, TX 78216-2795 | 2019-08-31 |
| 1922650605 | Hw Diagnostics LLC | Radiology | 18652 Mckay Dr Ste 200, Humble, TX 77338-5716 | 2019-07-12 |
| 1780246561 | Imaging Consultants | Radiology | 7250 Dallas Pkwy Ste 400, Plano, TX 75024-4931 | 2019-07-02 |
| 1366000531 | Interventional Partners, LLC | Radiology | 1650 Round Rock Ave Ste 100, Round Rock, TX 78681-4082 | 2019-06-03 |
| Find all providers with the same taxonomy | ||||
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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.