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

Mr. Christopher Glen Ilacqua, MD

Individual provider Athletic Trainer · NPI 1528291127

Mr. Christopher Glen Ilacqua, MD is a Physical Medicine and Rehabilitation in Southbridge, Massachusetts. Graduated from Tufts University School of Medicine in 2015, 11 years ago. Practices with Umass Memorial Medical Group Inc, a 2,467-clinician group, works from 4 locations, accepts Medicare assignment and offers telehealth. Licensed in Massachusetts and Pennsylvania.

Years since qualifying
11
Trained at
Tufts University School of Medicine
Licensed in
MA, PA
In the registry since
2009
Specialties on file
3
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Practice location Address checks out

100 S St
Southbridge, MA 01550-4051
Phone: (508) 909-8590
Fax: (508) 909-8589
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (3)

  • 123 Summer Street, Worcester, MA 01608 — (508) 363-6208
  • 3401 N Broad St Lowr Level, Philadelphia, PA 19140-5103 — (215) 707-7020
  • 1800 Lombard St, Philadelphia, PA 19146 — (215) 893-2600

Specialties & licences

Physical Medicine & Rehabilitation Physician (primary) Taxonomy 208100000X · Licence 1017464 (MA)
Athletic Trainer Taxonomy 2255A2300X · Licence 2015 (MA)
Physical Medicine & Rehabilitation Physician Taxonomy 208100000X · Licence MD467051 (PA)

Record details

NPI number1528291127
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedAugust 29, 2009
Last updated in NPPESApril 15, 2024
Certification dateApril 15, 2024
Mailing addressPo Box 415348, Boston, MA 02241-5348

Medicare enrollment

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

Medicare specialtyPHYSICAL MEDICINE AND REHABILITATION
Medical schoolTUFTS UNIVERSITY SCHOOL OF MEDICINE
Graduated 2015 (11 years in practice)
Group practice Umass Memorial Medical Group Inc — 2467 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in Southbridge