Individual provider Active NPI

Radmila Stevanovic, DDS

  • Dentist
  • Oak Park, IL
National Provider Identifier
1003595133
Registry record updated Dec 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019.034515 Issued in IL
Practice address
1 Chicago Ave
Oak Park, IL 60302-2432
Phone
(708) 948-7744
NPI assigned
Jul 17, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2901602842 MI
Dentist 122300000X 019.034515 IL Primary

Addresses

Primary practice location

1 Chicago Ave
Oak Park, IL 60302-2432

Mailing address

4 Elm Creek Dr Apt 309
Elmhurst, IL 60126-5286
Phone (901) 277-3905

Other practice location 1

712 E 87th St
Chicago, IL 60619-6246
Phone (773) 783-9000

Other practice location 2

2279 N Park Dr
Holland, MI 49424-8547
Phone (616) 392-1500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240212002265 IL Order and Referring Only - DentistPractitioner - Dentist 1254774797

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019.034515ILMDDentist
2901602842MIMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Pro Dental Il - Chad Wise PC Dentist CurrentSince Sep 23, 2024 Accepting new patients
D2 Dental of Lansing, P.C. PastSince Jul 23, 2023 Accepting new patients
Smiling Dental International P.C. Dentist PastSince Apr 6, 2021 Accepting new patients

Networks

  • devoted network organization-734447cc-691b-4aa7-a112-9c9c8698dcc9
  • IL HMO C-SNP
  • devoted network organization-27eb9117-6975-449a-a7ad-909243995ddc

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1689552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765411200000",
    "number": "1003595133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 ELM CREEK DR APT 309",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601265286",
            "telephone_number": "901-277-3905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CHICAGO AVE",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603022432",
            "telephone_number": "708-948-7744"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "712 E 87th St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606196246",
            "country_code": "US",
            "telephone_number": "773-783-9000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2279 N Park Dr",
            "address_purpose": "LOCATION",
            "city": "Holland",
            "state": "MI",
            "postal_code": "494248547",
            "country_code": "US",
            "telephone_number": "616-392-1500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STEVANOVIC",
        "first_name": "RADMILA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-17",
        "last_updated": "2025-12-11",
        "certification_date": "2025-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901602842",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019.034515",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Park, IL

Sources for this page

Verify at the official NPI Registry.