Ivancevic, Nikola

Ivancevic, Nikola is an sole proprietor health care provider with primary practice located at 5646 St Charles Rd Suite B, Berkeley IL 60163. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Foot Surgery, which is considered as his primary health care specialty. Ivancevic, Nikola can be contacted via phone (630) 782-6557.

Contact Information

Primary practice address
5646 St Charles Rd Suite B Berkeley IL 60163
Phone: (630) 782-6557
Fax: (630) 782-6559
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Foot Surgery 213ES0131X 016-004831 Illinois

Profile Details

NPI number 1972685410
LBN Legal business name Ivancevic, Nikola
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 20th, 2006
Last updated Nov 4th, 2016 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1972685410 NPPES
Illinois MEDICAID 016-004831

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