Organization
THOMAS A PAVLOVIC MD SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS PAVLOVIC MD (PRESIDENT)
(847) 696-1200
Entity
Organization
Contact information
Practice address
1875 DEMPSTER ST, #604, PARK RIDGE, IL 60068-1186
(847) 696-1200
(847) 696-1203
Mailing address
1875 DEMPSTER ST, #604, PARK RIDGE, IL 60068-1186
(847) 696-1200
(847) 696-1203
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
036041714
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036041714
—
IL
01
—
4901064
BCBS
IL
Enumeration date
11/22/2006
Last updated
04/19/2012
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