Provider Demographics
NPI:1619119039
Name:ALEKSIC, LJILJANA (OD)
Entity Type:Individual
Prefix:DR
First Name:LJILJANA
Middle Name:
Last Name:ALEKSIC
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1331 N 7TH ST STE 100
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85006-2765
Mailing Address - Country:US
Mailing Address - Phone:602-222-2234
Mailing Address - Fax:602-222-3025
Practice Address - Street 1:1331 N 7TH ST STE 100
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85006-2765
Practice Address - Country:US
Practice Address - Phone:602-222-2234
Practice Address - Fax:602-222-3025
Is Sole Proprietor?:No
Enumeration Date:2009-03-31
Last Update Date:2020-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1672152WP0200X, 152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
No152WP0200XEye and Vision Services ProvidersOptometristPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ162784Medicare PIN
AZZ162074Medicare PIN