Provider Demographics
NPI:1538326426
Name:DUKAREVICH, IGOR (DPM)
Entity Type:Individual
Prefix:DR
First Name:IGOR
Middle Name:
Last Name:DUKAREVICH
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:660 DUNHILL DR
Mailing Address - Street 2:
Mailing Address - City:BUFFALO GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60089-1513
Mailing Address - Country:US
Mailing Address - Phone:224-381-9438
Mailing Address - Fax:224-639-1997
Practice Address - Street 1:1835 N 19TH AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:MELROSE PARK
Practice Address - State:IL
Practice Address - Zip Code:60160-2040
Practice Address - Country:US
Practice Address - Phone:708-450-0705
Practice Address - Fax:708-345-0423
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-19
Last Update Date:2015-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL016005409213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery