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General NPI Number Information
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NPI Number | 1073599775
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Entity Type | Individual
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Provider Name | JASMINKA KOSTIC MD
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Gender | Female
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Dates
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Enumeration Date | 12/15/2005
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Last Update Date | 02/28/2017
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Provider Practice Location Address
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Address Line | 3114 W IRVING PARK RD
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City | CHICAGO
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State | IL
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Zip | 60618-3406
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Country | US
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Telephone | 773-588-6680
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Fax | 773-588-6451
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Provider Business Mailing Address
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Address Line | 3114 W IRVING PARK RD
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City | CHICAGO
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State | IL
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Zip | 60618-3406
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Country | US
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Telephone | 773-588-6680
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Fax | 773-588-6451
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 036104292
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 036104292
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License Number State | IL
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