Healthcare Provider Details

I. General information

NPI: 1780387043
Provider Name (Legal Business Name): SAID JUSIC DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2023
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

830 W END CT STE 500
VERNON HILLS IL
60061-1379
US

IV. Provider business mailing address

2650 RIDGE AVE STE 1223
EVANSTON IL
60201-1700
US

V. Phone/Fax

Practice location:
  • Phone: 847-522-8900
  • Fax: 847-680-6177
Mailing address:
  • Phone: 847-570-2040
  • Fax: 847-733-5315

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number036176708
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: