Individual
DR. NIKOLA IVANCEVIC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
5646 ST CHARLES RD, SUITE B, BERKELEY, IL 60163
(630) 782-6557
(630) 782-6559
Mailing address
5646 ST CHARLES RD, SUITE B, BERKELEY, IL 60163
(630) 782-6557
(630) 782-6559
Taxonomy
Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
Primary
016-004831
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
016-004831
—
IL
Enumeration date
10/20/2006
Last updated
11/04/2016
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