| Ilic Renal And Hypertension Associates, P.a. | |
|
3825 E Devonshire Ct Bloomington IN 47408-9699 | |
| (812) 837-3223 | |
| Not Available |
| Full Name | Ilic Renal And Hypertension Associates, P.a. |
|---|---|
| Speciality | Internal Medicine |
| Location | 3825 E Devonshire Ct, Bloomington, Indiana |
| Authorized Official Name and Position | Ljubomir Ilic (PRESIDENT) |
| Authorized Official Contact | 8128373515 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ilic Renal And Hypertension Associates, P.a. 3825 E Devonshire Ct Bloomington IN 47408-9699 Ph: (812) 837-3223 | Ilic Renal And Hypertension Associates, P.a. 3825 E Devonshire Ct Bloomington IN 47408-9699 Ph: (812) 837-3223 |
| NPI Number | 1033768619 |
|---|---|
| Provider Enumeration Date | 09/06/2019 |
| Last Update Date | 06/15/2023 |
| Medicare PECOS PAC ID | 2769817402 |
|---|---|
| Medicare Enrollment ID | O20230726002487 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033768619 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| 207RN0300X | Internal Medicine - Nephrology | (* (Not Available)) | Primary |
| Provider Name | Ljubomir Ilic |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1750348843 PECOS PAC ID: 7113020439 Enrollment ID: I20201123001280 |
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