Individual
KATHLEEN M BILAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
6525 W SACK DR STE 105, GLENDALE, AZ 85308-7106
(602) 274-4484
(602) 287-9406
Mailing address
300 W CLARENDON AVE STE 350, PHOENIX, AZ 85013-3497
(602) 274-4484
(602) 287-9406
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1586
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1022820
NCCPA CERTIFICATE
AZ
Enumeration date
03/20/2007
Last updated
04/06/2011
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