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General NPI Number Information
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NPI Number | 1497610521
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Entity Type | Organization
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Legal Business Name | ILUMIWELL PLCC
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Dates
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Enumeration Date | 12/20/2025
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Last Update Date | 12/20/2025
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Provider Practice Location Address
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Address Line | 15230 W LA SALLE AVE
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City | LAKEWOOD
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State | CO
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Zip | 80228-5520
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Country | US
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Telephone | 720-414-3265
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Fax | 720-414-1724
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Provider Business Mailing Address
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Address Line | 12081 W ALAMEDA PKWY # 444
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City | LAKEWOOD
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State | CO
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Zip | 80228-2701
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Country | US
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Telephone | 720-414-3265
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Fax | 720-414-1724
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Authorized Official
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Title or Position | MEMBER
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Name | DR. ZORAN LESIC
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Credential | MD
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Telephone | 720-933-0354
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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