Provider Demographics
NPI:1013263219
Name:MARKOVIC, JELENA (MD)
Entity Type:Individual
Prefix:
First Name:JELENA
Middle Name:
Last Name:MARKOVIC
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7301 N LINCOLN AVE
Mailing Address - Street 2:STE 183
Mailing Address - City:LINCOLNWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60712-1736
Mailing Address - Country:US
Mailing Address - Phone:224-766-7669
Mailing Address - Fax:
Practice Address - Street 1:402 W COUNTRY CLUB RD
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:NM
Practice Address - Zip Code:88201-5247
Practice Address - Country:US
Practice Address - Phone:575-627-9500
Practice Address - Fax:575-627-9535
Is Sole Proprietor?:No
Enumeration Date:2012-07-25
Last Update Date:2019-12-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NMMD2015-0457207R00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine