Individual
HOWARD JAY ILIVICKY
Active
Individual
HOWARD JAY ILIVICKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
118786
MO
2084P0800X
Psychiatry Physician
Primary
MD61660624
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
122112
BLUE CROSS BLUE SHIELD
—
01
—
415921
HEALTHLINK
—
Enumeration date
06/23/2005
Last updated
04/08/2025
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