Christopher Glen Ilacqua (NPI# 1528291127, PAC ID# 9931432960) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICAL MEDICINE AND REHABILITATION.
| Nation Provider ID (NPI) | 1528291127 |
| PAC ID by PECOS | 9931432960 |
| Professional Enrollment ID | I20190606001819 |
| Full Name | Christopher Glen Ilacqua |
| Organization Legal Name | UNIVERSITY OF PENN MEDICAL GROUP |
| Address |
800 Spruce St Philadelphia PA 19107-6130 |
| Phone Number | 2158297923 |
| Gender | M |
| Medical School | TUFTS UNIVERSITY SCHOOL OF MEDICINE |
| Graduation Year | 2014 |
| Primary Specialty | PHYSICAL MEDICINE AND REHABILITATION |
| Group Practice PAC ID | 6204730955 |
| Number of Group Practice Members | 2443 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 390111 | HOSPITAL OF UNIV OF PENNSYLVANIA |
| 390226 | PENNSYLVANIA HOSPITAL |
| 390223 | PENN PRESBYTERIAN MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 1800 Lombard Street Ground Floor, Phys Med and Rehab Ritten, Philadelphia, PA 19146-1498 | 2158932600 | UNIVERSITY OF PENN MEDICAL GROUP |
| 800 Spruce St, Philadelphia, PA 19107-6130 | 2158297923 | UNIVERSITY OF PENN MEDICAL GROUP |
| Organization Legal Name | UNIVERSITY OF PENN MEDICAL GROUP |
| Physicians | 2545 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Lauren Price | Physician Assistant | University of Penn Medical Group | 3400 Spruce Street 5 White Bldg, Oral and Maxillofacial Surgery Hup, Philadelphia, PA 19104-4206 |
| Zachary James Gaskill | Family Medicine | University of Penn Medical Group | 3620 Hamilton Walk Fl, 1 John Morgan Bldg Hyperbaric Medicine, Philadelphia, PA 19104-4800 |
| Jane Han | Physical Medicine and Rehabilitation | University of Penn Medical Group | 800 Spruce Street 10th Floor, Pah Inpatient Consult Services, Philadelphia, PA 19107-5701 |
| Meaghan Sarah Roche | Nephrology | University of Penn Medical Group | 51 N 39th Street 2 Mob, Uphs/presbyterian Division of Renal Electrolyte, Philadelphia, PA 19104-2640 |
| Janae Kathleen Heath | Pulmonary Disease | University of Penn Medical Group | 3400 Civic Ctr Blvd 1st, Harron Lung PCam, Philadelphia, PA 19104-4306 |
| Lauren Boccagno | Nurse Practitioner | University of Penn Medical Group | 3823 Market St, Philadelphia, PA 19104-3145 |
| Davoren Ann Chick | Hospitalist | University of Penn Medical Group | 51 N 39th Stret, Hospital Med Presby, Philadelphia, PA 19104-2640 |
| Michelle Liana Hershman | Diagnostic Radiology | University of Penn Medical Group | 1840 S St, Suite 3, Philadelphia, PA 19146-7422 |
| Marian Vanlandingham Moseley | Psychiatry | University of Penn Medical Group | 3535 Market St, 5th, Philadelphia, PA 19104-3309 |
| Robert E Burke | Internal Medicine | University of Penn Medical Group | 3615 Chestnut St, Philadelphia, PA 19104-2612 |
| Street Address |
800 SPRUCE ST |
| City | PHILADELPHIA |
| State | PA |
| Zip | 19107-6130 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Meredith Mooney-levin | Certified Registered Nurse Anesthetist (crna) | Society Hill Anesthesia Consultants PC | 800 Spruce St, Philadelphia, PA 19107-6130 |
| Brigid Kirlin Squilla | Certified Registered Nurse Anesthetist (crna) | Society Hill Anesthesia Consultants PC | 800 Spruce St, Philadelphia, PA 19107-6130 |
| Subash C Reddy | Anesthesiology | Society Hill Anesthesia Consultants PC | 800 Spruce St, Philadelphia, PA 19107-6130 |
| Brunilda Plaku | Certified Registered Nurse Anesthetist (crna) | Society Hill Anesthesia Consultants PC | 800 Spruce St, Philadelphia, PA 19107-6130 |
| Anne Gibson | Certified Registered Nurse Anesthetist (crna) | Society Hill Anesthesia Consultants PC | 800 Spruce St, Philadelphia, PA 19107-6130 |
| Robert M Andrews | Certified Registered Nurse Anesthetist (crna) | Society Hill Anesthesia Consultants PC | 800 Spruce St, Philadelphia, PA 19107-6130 |
| Laurie Gocial | Certified Registered Nurse Anesthetist (crna) | Society Hill Anesthesia Consultants PC | 800 Spruce St, Philadelphia, PA 19107-6130 |
| Pamela Polise | Anesthesiology | Society Hill Anesthesia Consultants PC | 800 Spruce St, Philadelphia, PA 19107-6130 |
| Kunal Desai | Anesthesiology | Society Hill Anesthesia Consultants PC | 800 Spruce St, Philadelphia, PA 19107-6130 |
| Nancy G Molder | Certified Registered Nurse Anesthetist (crna) | Society Hill Anesthesia Consultants PC | 800 Spruce St, Philadelphia, PA 19107-6130 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Rene Rubin | Hematology | Rittenhouse Hematology and Oncology | 207 N Broad St, 6th Floor, Philadelphia, PA 19107-1500 |
| Jean M Koka | Hematology/oncology | Rittenhouse Hematology and Oncology | 207 N Broad St, 6th Floor, Philadelphia, PA 19107-1500 |
| Arnold T Berman | Orthopedic Surgery | Berman Orthopedics Institute | 221 N Broad St, Philadelphia, PA 19107-1502 |
| Aisha N Qazi | Neurology | Drexel University | 219 N Broad St 7th Floor, Drexel Neurology, Philadelphia, PA 19107-1506 |
| Lissa B Levin Mizrahi | Nephrology | Drexel University | 219 N Broad St 9th Floor, Drexel Nephrology, Philadelphia, PA 19107-1506 |
| Andres Castellanos | General Surgery | Drexel University | 219 N Broad St 8th Floor, Drexel Surgery, Philadelphia, PA 19107-1506 |
| Matthew William Lawrence | Vascular Surgery | Drexel University | 219 N Broad St, Suite 8, Philadelphia, PA 19107-1506 |
| John Charles Madara | Pulmonary Disease | Drexel University | 219 N Broad St 9th Floor, Drexel Pulmonary, Philadelphia, PA 19107-1506 |
| Owen C Montgomery | Obstetrics/gynecology | Drexel University | 219 N Broad St 9th Floor, Drexel Nutritional Counseling, Philadelphia, PA 19107-1506 |
| Gediminas Gliebus | Neurology | Drexel University | 219 N Broad St 7th Floor, Drexel Neurology, Philadelphia, PA 19107-1506 |
| Find all physicians in zip 19107 | |||
| City | PHILADELPHIA |
| Zip Code | 19107 |
| Specialty | PHYSICAL MEDICINE AND REHABILITATION |
| City + Specialty | PHILADELPHIA + PHYSICAL MEDICINE AND REHABILITATION |
Please comment or provide details below to improve the information on Christopher Glen Ilacqua.
| 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.