MR. WILLIAM BLAKE CIVILETTA-KALICH (PA) – Physician Assistant, NPI 1386607356
Preparing for Medicare enrollment?
Use our CMS-855 prep checklist: which form applies (855I, 855O, or 855A), readiness score, NPPES field map, and Section 12 documents. Reassignment uses CMS-855I Section 4F—not the discontinued CMS-855R form.
Open Medicare 855 Prep tool →Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Loading map...
Provider Addresses for MR. WILLIAM BLAKE CIVILETTA-KALICH (PA)
2361 PAYSPHERE CIRCLE
CHICAGO, IL 60674
Phone: (414) 325-7246
Fax: (414) 325-3770
Type: Mailing
Cancer Treatment Centers of America at Midwestern Regional Medical Center, 2520, Elisha Avenue, Zion, Lake County, Illinois, 60099, United States
ZION, IL 60099
Phone: (414) 325-7246
Fax: (414) 325-3770
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
Loading prescription activity...
Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
No Medicare enrollment or revalidation data available for this provider in our database.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 60674)
Loading plans...
Group practice members
| Name | Specialty | State |
|---|---|---|
| Thoracic Surgery | OK | |
| Interventional Radiology, Diagnostic Radiology | IL | |
| General Surgery, Surgical Oncology | IL | |
| Hematology/Oncology, Internal Medicine | IL | |
| Pulmonary Disease | IL | |
| Radiation Oncology | IL | |
| Registered Dietitian Or Nutrition Professional | NY | |
| Medical Oncology | IL | |
| Nurse Practitioner | IL | |
| P A T H O L O G Y | IL |
Reviews
All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.
No reviews yet. Be the first to share your experience — your opinion helps families compare providers.