Provider Demographics
NPI:1437191822
Name:DJUROVIC, ZARIJA (MD)
Entity Type:Individual
Prefix:
First Name:ZARIJA
Middle Name:
Last Name:DJUROVIC
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6059 W. BELMONT AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60634
Mailing Address - Country:US
Mailing Address - Phone:773-237-7525
Mailing Address - Fax:773-237-7486
Practice Address - Street 1:6059 W. BELMONT AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60634
Practice Address - Country:US
Practice Address - Phone:773-237-7525
Practice Address - Fax:773-237-7486
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-12
Last Update Date:2012-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036052821208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036052821Medicaid
IL200904Medicare PIN
IL036052821Medicaid