Healthcare Provider Details

I. General information

NPI: 1710017355
Provider Name (Legal Business Name): BILL G SBILIRIS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/06/2007
Last Update Date: 11/12/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6015 W PEORIA AVE
GLENDALE AZ
85302-1213
US

IV. Provider business mailing address

6015 W PEORIA AVE
GLENDALE AZ
85302-1213
US

V. Phone/Fax

Practice location:
  • Phone: 623-344-4400
  • Fax: 623-344-4450
Mailing address:
  • Phone: 623-344-4400
  • Fax: 623-344-4450

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number23606
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: