Individual
DANA BOSKOVICH TASIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2650 RIDGE AVE, EVANSTON, IL 60201-1718
(847) 570-2760
Mailing address
2650 RIDGE AVE, ANESTHESIOLOGY DEPARTMENT, EVANSTON, IL 60201-1718
(312) 752-7135
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
01060162A
IN
207L00000X
Anesthesiology Physician
01060162A
IN
207L00000X
Anesthesiology Physician
036141385
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000371979
ANTHEM BCBS
IN
05
—
200531900A
—
IN
Enumeration date
05/05/2006
Last updated
05/11/2017
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