LIDIA S. ILCUS M.D. – NPI #1811950090
Military Health Care Provider

Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes.

LIDIA ILCUS is a military health care provider located in ENID, OK. NPPES has assigned the NPI number 1811950090 to LIDIA ILCUS on April 10, 2006. It is a Type-1 NPI, indicating this NPI number is associated with an individual. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 171000000X from the Health Care Provider Taxonomy code set, which is classified as Military Health Care Provider.

The NPI profile was previously updated about 5 years ago on Mar 05, 2021. See the complete NPI profile for LIDIA ILCUS below.

NPI Profile for
LIDIA S. ILCUS

NPI Number
1811950090
Enumeration Date

(more than 20 years ago)
Entity Type
Type-1  Individual (Female)
Legal Name
LIDIA S. ILCUS
Credentials
M.D.
Primary location
71 MDG
527 GOTT ROAD
ENID, OK 73705
Phone: (580) 213-7494 Fax:
Mailing address
Same as primary location
Sole Proprietor
No
Updated
Certification Date
Feb 17, 2021

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
171000000X
- Military Health Care Provider (Primary)
207R00000X
- Internal Medicine
FL ME 75062

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.