Individual
LJUBOMIR M ILIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
550 S LANDMARK AVE, BLOOMINGTON, IN 47403-3239
(812) 676-4660
(812) 676-4501
Mailing address
PO BOX 44008, JACKSONVILLE, FL 32231-4008
(904) 383-1013
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
ME133258
FL
207RN0300X
Nephrology Physician
Primary
01084851A
IN
207RN0300X
Nephrology Physician
ME133258
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2128438
—
MA
Enumeration date
05/01/2006
Last updated
08/04/2025
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