MEDICARE: ACTS OF KIDNESS PEDIATRICS PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	41887	AZ

General Provider Information

NPI Number	:	1942655758
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ACTS OF KIDNESS PEDIATRICS PLLC

Provider Business Mailing Address
First Line	:	861 N HIGLEY RD
Second Line	:	SUITE B101
City	:	GILBERT
State	:	AZ
Zip	:	85234-9602
Country	:	US
Telephone Number	:	480-664-6400
Fax Number	:

Provider Business Practice Location Address
First Line	:	861 N HIGLEY RD
Second Line	:	SUITE B101
City	:	GILBERT
State	:	AZ
Zip	:	85234-9602
Country	:	US
Telephone Number	:	480-664-6400
Fax Number	:

Authorized Official
Title or Position	:	PHYSICIAN/OWNER
Name	:	ALISON L WILCOCK
Credential	:	MD
Telephone Number	:	480-664-6400

Provider Enumeration Date	:	04/29/2016
Last Update Date	:	04/29/2016

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