Provider Demographics
NPI:1437137221
Name:VUJOVIC, POLLYANNA CIMBALJEVICH (FNP-BC)
Entity Type:Individual
Prefix:MS
First Name:POLLYANNA
Middle Name:CIMBALJEVICH
Last Name:VUJOVIC
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:131 CLOVER DR
Mailing Address - Street 2:
Mailing Address - City:SUGAR GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60554-9228
Mailing Address - Country:US
Mailing Address - Phone:812-453-2308
Mailing Address - Fax:877-477-3385
Practice Address - Street 1:1441 BRANDING AVE
Practice Address - Street 2:SUITE 310
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60515-1160
Practice Address - Country:US
Practice Address - Phone:630-725-2333
Practice Address - Fax:877-950-0072
Is Sole Proprietor?:No
Enumeration Date:2006-01-03
Last Update Date:2015-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71000605A207Q00000X
IL209007868363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN282330CMedicare ID - Type Unspecified