MEDICARE: MILA ZELENKOVICH, D.D.S.,LTD.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry		IL

General Provider Information

NPI Number	:	1154485191
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MILA ZELENKOVICH, D.D.S.,LTD.

Provider Business Mailing Address
First Line	:	3208 N MAJOR AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60634-4332
Country	:	US
Telephone Number	:	773-777-1111
Fax Number	:	773-777-0730

Provider Business Practice Location Address
First Line	:	3208 N MAJOR AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60634-4332
Country	:	US
Telephone Number	:	773-777-1111
Fax Number	:	773-777-0730

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. MILA ZELENKOVICH
Credential	:	D.D.S.
Telephone Number	:	773-777-1111

Provider Enumeration Date	:	12/21/2006
Last Update Date	:	08/22/2020

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