Organization
ILIC RENAL AND HYPERTENSION ASSOCIATES, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LJUBOMIR ILIC MD (PRESIDENT)
(812) 837-3515
Entity
Organization
Contact information
Practice address
3825 E DEVONSHIRE CT, BLOOMINGTON, IN 47408-9699
(812) 837-3223
Mailing address
3825 E DEVONSHIRE CT, BLOOMINGTON, IN 47408-9699
(812) 837-3223
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
207RN0300X
Nephrology Physician
Primary
—
—
Other
Enumeration date
09/06/2019
Last updated
06/15/2023
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