Provider Demographics
NPI:1184881740
Name:ZARIJA DJUROVIC MD
Entity type:Organization
Organization Name:ZARIJA DJUROVIC MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ZARIJA
Authorized Official - Middle Name:
Authorized Official - Last Name:DJUROVIC
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:773-725-6666
Mailing Address - Street 1:PO BOX 18433
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60618-0433
Mailing Address - Country:US
Mailing Address - Phone:773-725-6666
Mailing Address - Fax:
Practice Address - Street 1:3172 N MILWAUKEE AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60618-6633
Practice Address - Country:US
Practice Address - Phone:773-725-6666
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-21
Last Update Date:2008-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036052821208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036052821OtherSTATE LICENSE