Active NPI
Miljen Jagodic, M.D.
- Psychiatry Physician
- North Chicago, IL
National Provider Identifier
1952539918
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 125057160
- Practice address
- 3333 Green Bay Rd
Rfums, Department of Psychiatry
North Chicago, IL 60064-3037 - Phone
- (847) 578-8719
- Fax
- (847) 578-3328
- NPI assigned
- Jun 29, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 125057160 | IL | Primary |
Addresses
Primary practice location
3333 Green Bay Rd
Rfums, Department of Psychiatry
North Chicago, IL 60064-3037
Mailing address
1235 S White Oak Dr Apt 1636
Waukegan, IL 60085-8358
Phone (847) 688-1934
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 125057160 | IL | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1246233600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1246233600000",
"number": "1952539918",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1235 S WHITE OAK DR APT 1636",
"city": "WAUKEGAN",
"state": "IL",
"postal_code": "600858358",
"telephone_number": "847-688-1934"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3333 GREEN BAY RD",
"address_2": "RFUMS, DEPARTMENT OF PSYCHIATRY",
"city": "NORTH CHICAGO",
"state": "IL",
"postal_code": "600643037",
"telephone_number": "847-578-8719",
"fax_number": "847-578-3328"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JAGODIC",
"first_name": "MILJEN",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-06-29",
"last_updated": "2009-06-29",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "IL",
"license": "125057160",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in North Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.