DR. JOHN E LILJENQUIST MD NPI 1619977600

NPI Information

NPI: 1619977600
Provider Name: DR. JOHN E LILJENQUIST, MD
Classification: Internal Medicine - 207RE0101X
Entity Type: Individual

Specialization: Endocrinology, Diabetes & Metabolism

PECOS Registration: Yes

Address:
2220 E 25TH ST
IDAHO FALLS, ID
ZIP 83404
Phone: (208) 522-2996
Get Directions

DR. John E Liljenquist, MD is an endocrinology and diabetes and metabolism internal medicine in Idaho Falls, ID. The provider is an internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems. DR. John E Liljenquist, MD NPI is 1619977600. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2220 E 25TH ST
IDAHO FALLS, ID
ZIP 83404-542
Phone: (208) 522-2996
Fax: (208) 523-6025

The NPI 1619977600 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/30/2005 and was last updated on 6/2/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207RE0101X	Internal Medicine	Endocrinology, Diabetes & Metabolism	M4220	IDAHO	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	34512	OTHER	DELAWARE	BLUECROSS OF IDAHO
2	B02635	MEDICARE UPIN	IDAHO
3	25852	OTHER	IDAHO	BLUESHIELD OF IDAHO
4	1113732	MEDICARE ID-TYPE UNSPECIFIED	IDAHO
5	804012300	OTHER	IDAHO	HEALTHY CONNECTIONS
6	002530600	MEDICAID	IDAHO
7	113798100	OTHER	IDAHO	WYOMING CONSULTEC EDS
8	110008760	OTHER	IDAHO	RAILROAD MEDICARE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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