Individual
FATIMA VILICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
12202 DEER MOUNTAIN BLVD # 101-1740, KAMAS, UT 84036-9353
(435) 782-9384
(847) 919-8661
Mailing address
12202 DEER MOUNTAIN BLVD # 101-1740, KAMAS, UT 84036-9353
(435) 782-9384
(847) 919-8661
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
36097212
IL
207Q00000X
Family Medicine Physician
Primary
10369211205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
36097212
—
IL
Enumeration date
01/26/2006
Last updated
10/25/2021
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