Healthcare Provider Details

I. General information

NPI: 1245683770
Provider Name (Legal Business Name): BIANCA BILEK OD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/20/2016
Last Update Date: 11/17/2021
Certification Date: 11/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 S ADAMS RD STE 200
BIRMINGHAM MI
48009-6863
US

IV. Provider business mailing address

600 S ADAMS RD STE 200
BIRMINGHAM MI
48009-6863
US

V. Phone/Fax

Practice location:
  • Phone: 248-646-3733
  • Fax: 248-642-2566
Mailing address:
  • Phone: 248-646-3733
  • Fax: 248-642-2566

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number4901004993
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: