Healthcare Provider Details

I. General information

NPI: 1154973006
Provider Name (Legal Business Name): VELID SEFEROVIC DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2019
Last Update Date: 06/08/2022
Certification Date: 06/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9650 GROSS POINT RD STE 2900
SKOKIE IL
60076-5006
US

IV. Provider business mailing address

9650 GROSS POINT RD STE 2900
SKOKIE IL
60076-5006
US

V. Phone/Fax

Practice location:
  • Phone: 847-866-7846
  • Fax: 847-383-2210
Mailing address:
  • Phone: 847-866-7846
  • Fax: 847-383-2210

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number016005974
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: