Averbuch, Ilya M
Averbuch, Ilya M is an individual health care provider with primary practice located at 1000 Health Center Dr , Mattoon IL 61938. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Anesthesiology, Allopathic & Osteopathic Physicians / Pain Medicine. Allopathic & Osteopathic Physicians / Anesthesiology is his primary health care specialty. Averbuch, Ilya M can be contacted via phone (217) 258-2440.Contact Information
Primary practice address
1000 Health Center Dr
Mattoon IL 61938
Phone: (217) 258-2440
Fax: (217) 258-2186
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Anesthesiology | 207L00000X | MD032400E | Pennsylvania |
| Allopathic & Osteopathic Physicians / Pain Medicine | 207LP2900X | MD032400E | Pennsylvania |
| Allopathic & Osteopathic Physicians / Anesthesiology | 207L00000X | 036-068971 | Illinois |
Profile Details
| NPI number | 1316920358 |
|---|---|
| LBN Legal business name | Averbuch, Ilya M |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 23rd, 2005 |
| Last updated | Nov 12th, 2018 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1316920358 | NPPES |
| Pennsylvania | MEDICAID | 001000711 | |
| Pennsylvania | Other | 570900 | |
| Pennsylvania | MEDICAID | 0265705 |
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