Active NPI
Radovic Medical, SC
- Emergency Medicine Physician
- Bannockburn, IL
National Provider Identifier
1497308787
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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 DirectoryLocations
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.