Organization Active NPI

Radovic Medical, SC

  • Emergency Medicine Physician
  • Bannockburn, IL
National Provider Identifier
1497308787
Registry record updated Jul 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
RADOVIC MEDICAL, SC
Practice address
2515 Waukegan Rd # 100
Bannockburn, IL 60015-1569
Phone
(312) 504-6404
NPI assigned
Jul 17, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2024

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

Authorized official

Name
Aleksandar Radovic, MD
Title
President
Phone
(312) 504-6404

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X Primary

Addresses

Primary practice location

2515 Waukegan Rd # 100
Bannockburn, IL 60015-1569

Mailing address

2515 Waukegan Rd # 100
Bannockburn, IL 60015-1569
Phone (312) 504-6404

National Provider Directory

National Provider Directory

Locations

2515 Waukegan Rd
#100
Bannockburn, IL 60015
Phone (312) 504-6404

NPI Registry JSON

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

{
    "created_epoch": "1563321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720742400000",
    "number": "1497308787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2515 WAUKEGAN RD # 100",
            "city": "BANNOCKBURN",
            "state": "IL",
            "postal_code": "600151569",
            "telephone_number": "312-504-6404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2515 WAUKEGAN RD # 100",
            "city": "BANNOCKBURN",
            "state": "IL",
            "postal_code": "600151569",
            "telephone_number": "312-504-6404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RADOVIC MEDICAL, SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-17",
        "last_updated": "2024-07-12",
        "certification_date": "2024-07-12",
        "status": "A",
        "authorized_official_last_name": "RADOVIC",
        "authorized_official_first_name": "ALEKSANDAR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "312-504-6404",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bannockburn, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2024; 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.