Individual
DIJANA MIRKOVIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
5943 W IRVING PARK RD, CHICAGO, IL 60634
(773) 282-6111
Mailing address
3153 W 111TH ST, CHICAGO, IL 60655-2205
(773) 239-0702
(773) 239-0712
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
016005663
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
016.005663
PODIATRIC LICENSE NUMBER
IL
01
—
316.002829
LICENSED PODIATRY CONTROLLED SUBSTANCE
—
Enumeration date
05/13/2014
Last updated
03/07/2023
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