Individual
DR. OBRAD S KOKANOVIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
1818 N MEADE ST, APPLETON, WI 54911-3454
(920) 731-8900
(920) 738-5369
Mailing address
1860 PAYSPHERE CIR, CHICAGO, IL 60674-3404
(630) 469-2000
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
51767-020
WI
207RC0000X
Cardiovascular Disease Physician
Primary
51767-020
WI
207RI0011X
Interventional Cardiology Physician
01073758A
IN
207RI0011X
Interventional Cardiology Physician
036147379
IL
207RI0011X
Interventional Cardiology Physician
51767-020
WI
207RI0011X
Interventional Cardiology Physician
MD170724
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201215530
—
IN
01
—
51767-020
STATE OF WISCONSIN LICENSE
WI
01
—
PENDING
ANTHEM PROVIDER NUMBER
IN
Enumeration date
04/11/2011
Last updated
04/22/2026
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