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General NPI Number Information
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NPI Number | 1104159896
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Entity Type | Individual
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Provider Name | ZVEZDANA ILIC BOGOJEVIC M.D.
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Gender | Female
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Dates
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Enumeration Date | 09/11/2009
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Last Update Date | 10/11/2011
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Provider Practice Location Address
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Address Line | 3033 OGDEN AVE STE 101
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City | LISLE
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State | IL
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Zip | 60532-1673
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Country | US
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Telephone | 630-646-6200
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Fax | 630-428-4188
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Provider Business Mailing Address
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Address Line | 508 BONNIE BRAE PL
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City | RIVER FOREST
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State | IL
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Zip | 60305-1945
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Country | US
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Telephone | 708-771-4179
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Fax |
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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 | 036128650
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License Number State | IL
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