Individual provider Active NPI

Vladimir Vidanovic, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Maywood, IL
National Provider Identifier
1366459562
Registry record updated May 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
036114637 Issued in IL
Practice address
2160 S 1St Ave # Ems2280
Maywood, IL 60153-3328
Phone
(708) 327-2689
Fax
(312) 704-2737
NPI assigned
Aug 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Cytopathology Physician 207ZC0500X 036114637 IL
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 036114637 IL Primary
Hematology (Pathology) Physician 207ZH0000X 36114637 IL

Addresses

Primary practice location

2160 S 1St Ave # Ems2280
Maywood, IL 60153-3328

Mailing address

200 W Adams St Ste 225
Chicago, IL 60606-5212
Phone (312) 704-2885

Other practice location 1

300 Randall Rd # Ll
Geneva, IL 60134-4200
Phone (630) 208-4201

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060829000016 IL Practitioner - Pathology 2961406251 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Morris HospitalGroup PAC ID 1850372459, 115 clinicians

Practice addresses (Care Compare)

150 W High St
Morris, IL 60450-1463
Phone (815) 942-2932

300 Randall Rd
Geneva, IL 60134-4200
Phone (630) 208-4060

304 Randall Rd
Geneva, IL 60134-4200
Phone (630) 352-5450

660 N Westmoreland Rd
302 Lake Forest OBGYN
Lake Forest, IL 60045-1673
Phone (312) 926-6146

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.28 of 100Reported as group
Quality
73.53
Promoting interoperability
100
Improvement activities
40
Cost
70.73

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036114637ILMDCytopathology Physician
36114637ILMDHematology (Pathology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Faculty Foundation CurrentSince Feb 1, 2026 Accepting new patients
The Board of Trustees of the University of Illinois Blood Banking & Transfusion Medicine CurrentSince Jul 1, 2006 Accepting new patients
Loyola University Medical Center CurrentSince Aug 1, 2025 Accepting new patients
Loyola University Medical Center CurrentSince Aug 1, 2025 Accepting new patients
The Board of Trustees of the University of Illinois CurrentSince Jul 1, 2006 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Feb 1, 2026 Accepting new patients
Board of Trustees of the University of Illinois Past Accepting new patients
Central Dupage Physician Group Past Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

840 S Wood St
Chicago, IL 60612
Phone (312) 996-6711

1801 W Taylor St
Chicago, IL 60612
Phone (312) 355-1700

7732 Solution Ctr
Chicago, IL 60677
Phone (312) 355-6290

1740 W Taylor St
Chicago, IL 60612
Phone (312) 355-4000

1819 W Polk St
Chicago, IL 60612
Phone (312) 996-6604

1740 W Taylor St
#3446
Chicago, IL 60612

300 Randall Rd
Geneva, IL 60134
Phone (630) 208-4009

500 W Court St
Kankakee, IL 60901
Phone (800) 585-4119

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

2160 S 1st Ave
#2280
Maywood, IL 60153
Phone (708) 327-2689

2160 S 1st Ave
Maywood, IL 60153
Phone (708) 216-4400

150 W High St
Morris, IL 60450
Phone (815) 942-2129

Organizations & group practices 9

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778544000000",
    "number": "1366459562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 W ADAMS ST STE 225",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606065212",
            "telephone_number": "312-704-2885",
            "fax_number": "312-704-2737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2160 S 1ST AVE # EMS2280",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "601533328",
            "telephone_number": "708-327-2689",
            "fax_number": "312-704-2737"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 Randall Rd # Ll",
            "address_purpose": "LOCATION",
            "city": "Geneva",
            "state": "IL",
            "postal_code": "601344200",
            "country_code": "US",
            "telephone_number": "630-208-4201",
            "fax_number": "630-208-3489",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VIDANOVIC",
        "first_name": "VLADIMIR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2026-05-12",
        "certification_date": "2026-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZC0500X",
            "taxonomy_group": "",
            "desc": "Pathology, Cytopathology",
            "state": "IL",
            "license": "036114637",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "IL",
            "license": "036114637",
            "primary": true
        },
        {
            "code": "207ZH0000X",
            "taxonomy_group": "",
            "desc": "Pathology, Hematology",
            "state": "IL",
            "license": "36114637",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maywood, IL

Sources for this page

Verify at the official NPI Registry.