Organization
ZOFIA STEVANOVIC MD LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ZOFIA TERESA STEVANOVIC M.D. (OWNER)
(773) 736-2772
Entity
Organization
Contact information
Practice address
6058 W IRVING PARK RD, CHICAGO, IL 60634-2610
(773) 736-2772
Mailing address
6058 W IRVING PARK RD, CHICAGO, IL 60634-2610
(773) 736-2772
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
036054838
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036054838
—
IL
Enumeration date
10/03/2011
Last updated
10/13/2011
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