Provider Demographics
NPI:1104715820
Name:VASILIC, MILIJANA
Entity type:Individual
Prefix:
First Name:MILIJANA
Middle Name:
Last Name:VASILIC
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:980 E CREST AVE
Mailing Address - Street 2:
Mailing Address - City:ADDISON
Mailing Address - State:IL
Mailing Address - Zip Code:60101-6000
Mailing Address - Country:US
Mailing Address - Phone:773-503-9037
Mailing Address - Fax:
Practice Address - Street 1:310 S MAIN ST STE D
Practice Address - Street 2:
Practice Address - City:LOMBARD
Practice Address - State:IL
Practice Address - Zip Code:60148-2692
Practice Address - Country:US
Practice Address - Phone:630-652-0200
Practice Address - Fax:630-652-0300
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-30
Last Update Date:2025-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL242008366235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist