Provider Demographics
NPI:1477689081
Name:BIELAT, JULIA L (MD)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:L
Last Name:BIELAT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JULIA
Other - Middle Name:L
Other - Last Name:CASTILLO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2635 CHURCH RD STE 201
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60502-8943
Mailing Address - Country:US
Mailing Address - Phone:630-315-8700
Mailing Address - Fax:630-315-8777
Practice Address - Street 1:2635 CHURCH RD STE 201
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60502-8943
Practice Address - Country:US
Practice Address - Phone:630-315-8700
Practice Address - Fax:630-315-8777
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2020-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036108044207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036108044Medicaid
IL920540021OtherMEDICARE PTAN (INDIVIDUAL)
ILP01137348OtherRAILROAD MEDICARE (PROVIDER PTAN)
IL920540OtherMEDICARE PTAN (GROUP)
ILP01137348OtherRAILROAD MEDICARE (PROVIDER PTAN)