NPIMap

Organization Active NPI

Zofia Stevanovic MD LTD

  • Clinic/Center
  • Chicago, IL
National Provider Identifier
1356625875
Registry record updated Oct 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
036054838 Issued in IL
Legal business name
ZOFIA STEVANOVIC MD LTD
Practice address
6058 W Irving Park Rd
Chicago, IL 60634-2610
Phone
(773) 736-2772
NPI assigned
Oct 3, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2011

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

Authorized official

Name
Dr. Zofia Teresa Stevanovic, M.D.
Title
Owner
Phone
(773) 736-2772

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 036054838 IL Primary

Addresses

Primary practice location

6058 W Irving Park Rd
Chicago, IL 60634-2610

Mailing address

6058 W Irving Park Rd
Chicago, IL 60634-2610
Phone (773) 736-2772

Other identifiers 1

IdentifierTypeStateIssuer
036054838MedicaidIL

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1317600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318464000000",
    "number": "1356625875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6058 W IRVING PARK RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606342610",
            "telephone_number": "773-736-2772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6058 W IRVING PARK RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606342610",
            "telephone_number": "773-736-2772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ZOFIA STEVANOVIC MD LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-03",
        "last_updated": "2011-10-13",
        "status": "A",
        "authorized_official_last_name": "STEVANOVIC",
        "authorized_official_first_name": "ZOFIA",
        "authorized_official_middle_name": "TERESA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "773-736-2772",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "IL",
            "license": "036054838",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036054838",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.