Individual
DR. ILYA KATZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
11022 N 28TH DR STE 205, PHOENIX, AZ 85029
(602) 971-0304
(602) 971-0305
Mailing address
11022 N 28TH DR STE 205, PHOENIX, AZ 85029-5635
(602) 971-0304
(602) 971-0305
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
005220
AZ
208D00000X
General Practice Physician
005220
AZ
208D00000X
General Practice Physician
242526
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
437332
—
AZ
Enumeration date
07/25/2007
Last updated
07/24/2018
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