Provider Demographics
NPI:1891710026
Name:AIDA MIHAJLOVIC MD INC
Entity Type:Organization
Organization Name:AIDA MIHAJLOVIC MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AIDA
Authorized Official - Middle Name:
Authorized Official - Last Name:MIHAJLOVIC
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:708-481-8290
Mailing Address - Street 1:3700 W 203RD ST
Mailing Address - Street 2:SUITE 308
Mailing Address - City:OLYMPIA FIELDS
Mailing Address - State:IL
Mailing Address - Zip Code:60461-1180
Mailing Address - Country:US
Mailing Address - Phone:708-481-8290
Mailing Address - Fax:
Practice Address - Street 1:3700 W 203RD ST
Practice Address - Street 2:SUITE 308
Practice Address - City:OLYMPIA FIELDS
Practice Address - State:IL
Practice Address - Zip Code:60461-1180
Practice Address - Country:US
Practice Address - Phone:708-481-8290
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILG87238Medicare UPIN