Organization
GREEN PEDIATRICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BILJANA UZELAC M.D. (OWNER / PRESIDENT)
(219) 662-3931
Entity
Organization
Contact information
Practice address
8247 WICKER AVE, SAINT JOHN, IN 46373-8878
(219) 662-3931
Mailing address
PO BOX 1153, CROWN POINT, IN 46308-1153
(219) 662-3931
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
01064437A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201361020A
—
IN
Enumeration date
04/07/2016
Last updated
01/30/2017
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