# KATIA V ILIEVA

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1821195603
- **Gender:** F
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207P00000X | Emergency Medicine Physician | 036-096083 | IL | — |
| 207Q00000X | Family Medicine Physician | 036-096083 | IL | Yes |
| 2083X0100X | Occupational Medicine Physician | 036-096083 | IL | — |

## Other

- **Enumeration date:** 09/20/2006
- **Last updated:** 02/08/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 036096083 | BLUE SHIELD | IL |
| 01 | — | K34497 | MEDICARE | IL |