Individual
DR. SLOBODAN D VUCICEVIC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
036055452
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036055452
—
IL
01
—
2221384
BLUE CROSS BLUE SHIELD
IL
01
—
363203419
TAX IDENTIFICATION
IL
01
—
672600
MEDICARE ID TYPE UNSPECIF
IL
Enumeration date
08/10/2005
Last updated
06/21/2011
Update your record
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