Alexander Dzakovic, MD

Primary specialty

Pediatric Surgery PhysicianTaxonomy code 2086S0120X

License

036121385 Issued in IL

Practice address

2160 S 1St Ave
Surgery
Maywood, IL 60153-3328

Phone

(708) 327-2699

NPI assigned

Nov 4, 2006

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

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: adzakovic48346@direct.luhs.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Loyola University Medical Center

  dba Foster G. McGaw Hospital

  • General Acute Care Hospital
  • Maywood, IL
  • NPI 1376521575
  NPD
• Lurie Children's Medical Group, LLC

  dba LCMG

  • Pediatrics Physician
  • Chicago, IL
  • NPI 1992758544
  NPD (past)

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

{
    "created_epoch": "1162598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366588800000",
    "number": "1902985385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1887 N POE ST APT 1R",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606148974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2160 S 1ST AVE",
            "address_2": "SURGERY",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "601533328",
            "telephone_number": "708-327-2699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DZAKOVIC",
        "first_name": "ALEXANDER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-04",
        "last_updated": "2013-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "IL",
            "license": "036121385",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Dumont, MD
• Tanaka Junior Dune
• Kim Nancy Sison Duque, MD
• Katherine Duquette, MD
• Katherine Elizabeth Dux, DPM
• Jacqueline Marie Dziedzic, D.O.
• Jonathan Dzielski, DO
• Angela Eads, PHD
• Matthew Theodore Eakins, M.D.
• Bradley Davis Eames

• Pediatric Surgery Physician in Maywood, IL
• Providers in Maywood, IL by specialty
• Pediatric Surgery Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.