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Nikola Aleksandar Lukic

Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers

1969 W Ogden Ave, Chicago, IL 60612-3765

PECOS Enrollment

This provider is enrolled in PECOS as NIKOLA LUKIC.

Based on the most recent information from CMS, provider Nikola Aleksandar Lukic is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 3 days ago.

Profile Details

Provider ID
1750079448
Provider Type
Individual
Full Name
Lukic, Nikola Aleksandar
Title
Mr.
Credential
PA-C

Gender
Male
Sole Proprietor
No
Enumeration Date
5/1/2023
Last Updated
2/11/2025

Contact Information

Practice Location

1969 W Ogden Ave, Chicago, IL 60612-3765

(312) 864-6000

Unlisted Fax

Mailing Location

8333 Howard Ave, Munster, IN 46321-1838

Unlisted Phone

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363A00000X Primary	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License 085009584 Illinois

Nikola Aleksandar Lukic

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Walsh, Nicholas Tyler

Freeman, Taylar

Choi, Sophia

Schock, Lindsey

Rogowski, Wendy Ann

Shah, Palak K.

Miller, Barbara June

Villafranca-Escobar, Bessy Sarahi

Sims, Kevin E.

Rao, Prerana