Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Lillian Kim Ivansco, MD, MPH

Individual provider Diagnostic Radiology Physician · NPI 1043478605

Dr. Lillian Kim Ivansco, MD, MPH is a Diagnostic Radiology in Atlanta, Georgia. Graduated from Emory University School of Medicine in 2008, 18 years ago. Practices with The Southeast Permanente Medical Group, a 826-clinician group and accepts Medicare assignment. Licensed in Colorado, Georgia, Hawaii and Kansas and 1 more.

Years since qualifying
18
Trained at
Emory University School of Medicine
Licensed in
CO, GA, HI, KS, NE
In the registry since
2008
Specialties on file
5
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.
MPH — Master of Public Health
A graduate degree in population health.

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Practice location Address checks out

20 Glenlake Pkwy
Atlanta, GA 30328-3473
Phone: (404) 364-7285
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Diagnostic Radiology Physician (primary) Taxonomy 2085R0202X · Licence 069869 (GA)
Diagnostic Radiology Physician Taxonomy 2085R0202X · Licence MD17668 (HI)
Diagnostic Radiology Physician Taxonomy 2085R0202X · Licence 04-37114 (KS)
Diagnostic Radiology Physician Taxonomy 2085R0202X · Licence 27713 (NE)
Diagnostic Radiology Physician Taxonomy 2085R0202X · Licence 53370 (CO)

Record details

NPI number1043478605
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD , MPH
Sole proprietorNo
NPI enumeratedMay 29, 2008
Last updated in NPPESJanuary 10, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyDIAGNOSTIC RADIOLOGY
Medical schoolEMORY UNIVERSITY SCHOOL OF MEDICINE
Graduated 2008 (18 years in practice)
Group practice The Southeast Permanente Medical Group — 826 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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