Provider Demographics
NPI:1528759925
Name:FORCESKIE, LILY ANN
Entity type:Individual
Prefix:
First Name:LILY
Middle Name:ANN
Last Name:FORCESKIE
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 1:5959 W UTOPIA RD APT 2067
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-7162
Mailing Address - Country:US
Mailing Address - Phone:907-360-9505
Mailing Address - Fax:
Practice Address - Street 1:7700 W ARROWHEAD TOWNE CTR
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-8616
Practice Address - Country:US
Practice Address - Phone:623-486-2020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-16
Last Update Date:2024-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ002727152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist