MEDICARE: ILA LAHOOTI DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1427990860
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ILA LAHOOTI DO

Provider Business Mailing Address
First Line	:	395 W 12TH AVE FL 3
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43210-1267
Country	:	US
Telephone Number	:	614-293-3989
Fax Number	:	614-293-9789

Provider Business Practice Location Address
First Line	:	395 W 12TH AVE FL 3
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43210-1267
Country	:	US
Telephone Number	:	614-293-3989
Fax Number	:	614-293-3989

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/06/2026
Last Update Date	:	04/06/2026

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THE OHIO STATE UNIVERSITY WEXNER MEDICAL CENTER , 395 W 12TH AVENUE, THIRD FLOOR
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Directions to “ ILA LAHOOTI DO” Practice Location

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