Healthcare Provider Details

I. General information

NPI: 1770377095
Provider Name (Legal Business Name): DR. JELENA DJUROVIC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2025
Last Update Date: 04/09/2025
Certification Date: 04/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7165 CENTER AVE
HANOVER PARK IL
60133-3565
US

IV. Provider business mailing address

1320 TOWER RD STE 156
SCHAUMBURG IL
60173-4309
US

V. Phone/Fax

Practice location:
  • Phone: 773-946-8479
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number071011433
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: