Provider Demographics
NPI:1114000999
Name:VESKOVIC, KATARINA (MD)
Entity Type:Individual
Prefix:
First Name:KATARINA
Middle Name:
Last Name:VESKOVIC
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KATARINA
Other - Middle Name:
Other - Last Name:STOJANOVIC
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:180 HARVESTER DR
Mailing Address - Street 2:SUITE 110
Mailing Address - City:BURR RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60527-7594
Mailing Address - Country:US
Mailing Address - Phone:773-702-1061
Mailing Address - Fax:
Practice Address - Street 1:GOTTCHALK MEDICAL PLAZA 1 MEDCAL PLAZA
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92697-1447
Practice Address - Country:US
Practice Address - Phone:949-824-8600
Practice Address - Fax:949-824-1589
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2020-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036117731207R00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWA89106BMedicare PIN
I25118Medicare UPIN