MEDICARE: DR. MARY MARGARET LILKO DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	OS18531	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	GU4195397	OTHER	OH	MEDICARE PTAN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1902808983
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARY MARGARET LILKO DO

Provider Business Mailing Address
First Line	:	1221 JACARANDA BLVD
Second Line	:
City	:	VENICE
State	:	FL
Zip	:	34292-4520
Country	:	US
Telephone Number	:	941-766-5069
Fax Number	:	941-486-6419

Provider Business Practice Location Address
First Line	:	1221 JACARANDA BLVD
Second Line	:
City	:	VENICE
State	:	FL
Zip	:	34292-4520
Country	:	US
Telephone Number	:	941-766-5069
Fax Number	:	941-486-6419

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/10/2005
Last Update Date	:	02/09/2026

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