Dejan Kotur, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

038.012856 Issued in IL

Practice address

2604 Dempster St Ste 201
Park Ridge, IL 60068-8426

Phone

(708) 374-3726

NPI assigned

Jul 29, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1627516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627516800000",
    "number": "1386317949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2204 SHANNONDALE DR",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600481141",
            "telephone_number": "708-374-3726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2604 DEMPSTER ST STE 201",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600688426",
            "telephone_number": "708-374-3726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOTUR",
        "first_name": "DEJAN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-07-29",
        "last_updated": "2021-07-29",
        "certification_date": "2021-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038.012856",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "yourvitalitystudio.com",
            "affiliation": "N",
            "endpointDescription": "website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2604 Dempster St Ste 201",
            "city": "Park Ridge",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600688426",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Anna Korff, AGNP-C
• Robert G. Koss, M.D.
• Izabela Koszczuk
• Kasey Kotsiris, OTR/L
• Susan Kottra, LCSW
• Brenna Kathleen Kouzoukas, FNP-BC
• Ivan Kovbel, MD
• Robert Stephen Kozelka, DDS
• Kamila Kozicki-Bonnert, M.H.S.-CCC/SLP/L
• Donald John Koziol, M.D.

• Chiropractor in Park Ridge, IL
• Providers in Park Ridge, IL by specialty
• Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2021; 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.