Healthcare Provider Details

I. General information

NPI: 1003595133
Provider Name (Legal Business Name): RADMILA STEVANOVIC DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2023
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 CHICAGO AVE
OAK PARK IL
60302-2432
US

IV. Provider business mailing address

4 ELM CREEK DR APT 309
ELMHURST IL
60126-5286
US

V. Phone/Fax

Practice location:
  • Phone: 708-948-7744
  • Fax:
Mailing address:
  • Phone: 901-277-3905
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number2901602842
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number019.034515
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: