Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. WILLIAM BLAKE CIVILETTA-KALICH, PA
ActiveMR. WILLIAM BLAKE CIVILETTA-KALICH, PA is a Physician Assistant healthcare provider located in ZION, Illinois. NPI 1386607356 is currently active in the NPPES registry. Verify at CMS.
Physician Assistant · ZION, IL
Registration Details
- NPI Number
- 1386607356
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Apr 10, 2006 (20.331834305922 yrs)
- Last Updated
- Oct 9, 2018
- Licenses
-
1748023 (WI)085.003749 (IL)
Practice Information
- Address
-
2520 ELISHA AVENUEZION, IL, 60099Browse IL providers · Browse ZIP 60099
- Phone
- 4143257246
- Fax
- 4143253770
- Primary Specialty
-
Physician Assistant
363A00000X
- Additional Specialty
- Physician Assistant
Other Physician Assistant Providers in ZION, IL
| Name | Credential | NPI |
|---|---|---|
| LILY L ZHAO | P.A. | 1093873671 |
| MS. SAMATA J SHROFF | PA-C | 1558583468 |
| AMY D. RIZMAN | PA-C | 1508061409 |
| MRS. JALPA M PATEL | PA-C | 1710118112 |
| MS. ANN M GRIMES | PA-C | 1649401985 |
| MISS COURTNEY KAE ANDERSON | PA-C | 1497007363 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.