Provider Demographics
NPI:1922410471
Name:BAJIC, NICOLE NIKOLIC (MD)
Entity Type:Individual
Prefix:DR
First Name:NICOLE
Middle Name:NIKOLIC
Last Name:BAJIC
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1211 S ARLINGTON HEIGHTS RD
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60005-3142
Mailing Address - Country:US
Mailing Address - Phone:847-264-2222
Mailing Address - Fax:847-437-6841
Practice Address - Street 1:5841 S MARYLAND AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60637
Practice Address - Country:US
Practice Address - Phone:773-702-1864
Practice Address - Fax:773-834-9711
Is Sole Proprietor?:No
Enumeration Date:2014-06-02
Last Update Date:2018-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-146771207W00000X
IL390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program