LISA L ILLICH (MS) – Audiologist, NPI 1861467839

LISA L ILLICH (MS) is a healthcare provider. based in Seattle, Washington. specializing in QUALIFIED AUDIOLOGIST. They hold the professional credentials MS. They hold a License No. LD00001205 (WA). The NPI Number for LISA L ILLICH (MS) is 1861467839

Main info

Female
34 Years Of Experience
Accepts Medicare Assignment
Name
LISA L ILLICH (MS)
NPI
1861467839
Phone
Not provided
Address
PO BOX 50095
Enumeration Date
22 February 2006
Last Update Date
19 September 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2063686360
Graduation Year
1992 (34 years ago)
PAC ID
7012448103
Group Practice PAC ID
0446162697
Professional Enrollment ID
I20240930003727
Address ID
WA981339484SE10330NXXX402
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience64
Completeness75
Years active:20State licenses:1Digital endpointsOther names

273 QUALIFIED AUDIOLOGIST in WA

Provider Addresses for LISA L ILLICH (MS)

  • PO BOX 50095

    SEATTLE, WA 981455095

    Phone:

    Type: Mailing

  • 1959 NE PACIFIC ST.

    SEATTLE, WA 981950001

    Phone: (206) 520-5000

    Type: Location

  • Seattle Children's Research Institute Olive Lab Building, 1100, Olive Way, Central Business District, First Hill, Seattle, King County, Washington, 98101, United States

    MS:M4-PA

    SEATTLE, WA 981011873

    Phone: (206) 515-5811

    Type: Mailing

  • Virginia Mason Hospital & Seattle Medical Center, 1100, 9th Avenue, Central Business District, First Hill, Seattle, King County, Washington, 98101, United States

    SEATTLE, WA 981012756

    Phone: (206) 223-6600

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-09-30

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240930003727IQualified AudiologistWATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 98145)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0446162697View full group profile

Reviews

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Frequently asked questions

What identifier follows LISA L ILLICH (MS) across health systems?
The NPI 1861467839 uniquely identifies LISA L ILLICH (MS) in U.S. healthcare data.
Quick check: is LISA L ILLICH (MS) active?
Public NPPES data shows LISA L ILLICH (MS) with an active NPI status right now.
How should patients interpret LISA L ILLICH (MS)'s specialty?
The extract shows Audiologist for LISA L ILLICH (MS). Clinical services aligned with this taxonomy classification.
Is LISA L ILLICH (MS) tied to Seattle, Washington?
If you are local to Seattle, Washington, LISA L ILLICH (MS) may be relevant to your search.
Why is information missing for LISA L ILLICH (MS)?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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