Christopher Illick (NPI# 1609836998, PAC ID# 6406884279) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is GASTROENTEROLOGY.
Nation Provider ID (NPI) | 1609836998 |
PAC ID by PECOS | 6406884279 |
Professional Enrollment ID | I20050802000896 |
Full Name | Christopher Illick |
Organization Legal Name | DIGESTIVE DISEASE ASSOCIATES, LLC |
Address |
687 Main St Branford CT 06405-3612 |
Phone Number | 2034810315 |
Gender | M |
Credential | MD |
Medical School | COLUMBIA UNIVERSITY COLLEGE OF PHYSICIANS AND SURGEONS |
Graduation Year | 1998 |
Primary Specialty | GASTROENTEROLOGY |
Group Practice PAC ID | 5395644512 |
Number of Group Practice Members | 5 |
Accepts Medicare Assignment | Y |
Claim Control Number (CCN) | Legal Business Name |
---|---|
070022 | YALE-NEW HAVEN HOSPITAL |
Address | Phone | Organization |
---|---|---|
687 Main St, Branford, CT 06405-3612 | 2034810315 | DIGESTIVE DISEASE ASSOCIATES, LLC |
2 Church St S, Suite 412, New Haven, CT 06519-1717 | 2037874382 | DIGESTIVE DISEASE ASSOCIATES, LLC |
5 Pequot Park Rd, Suite 302, Westbrook, CT 06498-2856 | 8603990168 | DIGESTIVE DISEASE ASSOCIATES, LLC |
Organization Legal Name | DIGESTIVE DISEASE ASSOCIATES, LLC |
Physicians | 5 |
Name | Specialty | Organization | Address |
---|---|---|---|
Michael Phillip Dorfman | Gastroenterology | Digestive Disease Associates, LLC | 687 Main St, Branford, CT 06405-3612 |
Keri A Herzog | Gastroenterology | Digestive Disease Associates, LLC | 687 Main St, Branford, CT 06405-3612 |
Jackie J Chuong | Gastroenterology | Digestive Disease Associates, LLC | 687 Main St, Branford, CT 06405-3612 |
Frank A Bauer | Pathology | Digestive Disease Associates, LLC | 687 Main St, Branford, CT 06405-3612 |
Street Address |
687 MAIN ST |
City | BRANFORD |
State | CT |
Zip | 06405-3612 |
Name | Specialty | Organization | Address |
---|---|---|---|
Michael Phillip Dorfman | Gastroenterology | Digestive Disease Associates, LLC | 687 Main St, Branford, CT 06405-3612 |
Keri A Herzog | Gastroenterology | Digestive Disease Associates, LLC | 687 Main St, Branford, CT 06405-3612 |
Jackie J Chuong | Gastroenterology | Digestive Disease Associates, LLC | 687 Main St, Branford, CT 06405-3612 |
Frank A Bauer | Pathology | Digestive Disease Associates, LLC | 687 Main St, Branford, CT 06405-3612 |
Name | Specialty | Organization | Address |
---|---|---|---|
Patricia A Youngquist | Optometry | 120 Commercial Pkwy, Branford, CT 06405-2537 | |
Sushil Gupta | Pulmonary Disease | Pulmonary Care, PC | 14 Business Park Dr, Branford, CT 06405-2909 |
Rachel Creevy D'errico | Nurse Practitioner | Northeast Medical Group Inc | 500 E Main St, Branford, CT 06405-2912 |
Kyle Lynn Blomberg | Nurse Practitioner | Northeast Medical Group Inc | 500 E Main St, Branford, CT 06405-2912 |
Gloria J Greenidge | Clinical Social Worker | 388 E Main St, Suite 3, Branford, CT 06405-2914 | |
Jamelah T Stone | Clinical Social Worker | 500 E Main St, Suite 322, Branford, CT 06405-2929 | |
Faith Levin-irwin | Physical Therapy | Physical Therapy Services of Guilford LLC | 500 E Main St, Suite 310, Branford, CT 06405-2937 |
Janet M Smith | Physical Therapy | Physical Therapy Services of Guilford LLC | 500 E Main St, Suite 310, Branford, CT 06405-2937 |
Justine Gillen | Physical Therapy | Physical Therapy Services of Guilford LLC | 500 E Main St, Suite 310, Branford, CT 06405-2937 |
Phyllis L Quinn | Physical Therapy | Physical Therapy Services of Guilford LLC | 500 E Main St, Suite 310, Branford, CT 06405-2937 |
Find all physicians in zip 06405 |
City | BRANFORD |
Zip Code | 06405 |
Specialty | GASTROENTEROLOGY |
City + Specialty | BRANFORD + GASTROENTEROLOGY |
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Data Provider | Centers for Medicare & Medicaid Services (CMS) |
Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.