Provider Demographics
NPI:1932136181
Name:ZAKARIJA, MARIJA (MD)
Entity Type:Individual
Prefix:DR
First Name:MARIJA
Middle Name:
Last Name:ZAKARIJA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:611 W. PARK ST
Mailing Address - Street 2:FAPC
Mailing Address - City:URBANA
Mailing Address - State:IL
Mailing Address - Zip Code:61801
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:205 PARKER ST
Practice Address - Street 2:
Practice Address - City:BOSCOBEL
Practice Address - State:WI
Practice Address - Zip Code:53805
Practice Address - Country:US
Practice Address - Phone:608-375-4112
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2020-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI24441207P00000X
IL036055303207PE0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0360553032Medicaid
IL0360553034Medicaid
WI30398100Medicaid
IL05721369OtherBC/BS
IL05721369OtherBC/BS
ILD14506Medicare UPIN
ILK19631Medicare ID - Type Unspecified
IL0360553032Medicaid
ILK34641Medicare PIN