Provider Demographics
NPI:1689839383
Name:AARON A. ILK, DC, INC., PS
Entity Type:Organization
Organization Name:AARON A. ILK, DC, INC., PS
Other - Org Name:BELLEVUE SPINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:AARON
Authorized Official - Middle Name:A
Authorized Official - Last Name:ILK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:425-827-2302
Mailing Address - Street 1:1750 112TH AVE NE
Mailing Address - Street 2:SUITE E-165
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-3752
Mailing Address - Country:US
Mailing Address - Phone:425-827-2302
Mailing Address - Fax:425-454-2579
Practice Address - Street 1:1750 112TH AVE NE
Practice Address - Street 2:SUITE E-165
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-3752
Practice Address - Country:US
Practice Address - Phone:425-827-2302
Practice Address - Fax:425-454-2579
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-22
Last Update Date:2008-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00003665111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
2029270Medicare PIN
G8854313Medicare PIN