Provider Demographics
NPI:1467462796
Name:BOSKOVIC, SINISA (MD)
Entity Type:Individual
Prefix:DR
First Name:SINISA
Middle Name:
Last Name:BOSKOVIC
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:PO BOX 68979
Mailing Address - Street 2:
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60168-0979
Mailing Address - Country:US
Mailing Address - Phone:847-892-5001
Mailing Address - Fax:847-952-9451
Practice Address - Street 1:943 N PLUM GROVE RD STE B
Practice Address - Street 2:
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60173-4779
Practice Address - Country:US
Practice Address - Phone:847-892-5001
Practice Address - Fax:847-952-9451
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2021-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-097078207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036097078Medicaid
IL036097078Medicaid