MEDICARE: APICAL HEALTHCARE LLC

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	207R00000X	Internal Medicine Physician	01064700A	IN

General Provider Information

NPI Number	:	1881960433
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	APICAL HEALTHCARE LLC

Provider Business Mailing Address
First Line	:	327 E WAYNE ST
Second Line	:	STE 150
City	:	FORT WAYNE
State	:	IN
Zip	:	46802-2753
Country	:	US
Telephone Number	:	347-468-2394
Fax Number	:

Provider Business Practice Location Address
First Line	:	327 E WAYNE ST
Second Line	:	STE 150
City	:	FORT WAYNE
State	:	IN
Zip	:	46802-2753
Country	:	US
Telephone Number	:	347-468-2394
Fax Number	:

Authorized Official
Title or Position	:	SOLE MEMBER
Name	:	DAVID U ILO
Credential	:	M.D.
Telephone Number	:	347-468-2394

Provider Enumeration Date	:	03/28/2012
Last Update Date	:	12/03/2024

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Directions to “APICAL HEALTHCARE LLC ” Practice Location

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