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General NPI Number Information
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NPI Number | 1538326426
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Entity Type | Individual
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Provider Name | IGOR DUKAREVICH D.P.M.
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Gender | Male
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Dates
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Enumeration Date | 05/19/2008
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Last Update Date | 06/02/2015
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Provider Practice Location Address
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Address Line | 1835 N 19TH AVE SUITE 102
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City | MELROSE PARK
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State | IL
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Zip | 60160-2040
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Country | US
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Telephone | 708-450-0705
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Fax | 708-345-0423
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Provider Business Mailing Address
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Address Line | 660 DUNHILL DR
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City | BUFFALO GROVE
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State | IL
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Zip | 60089-1513
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Country | US
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Telephone | 224-381-9438
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Fax | 224-639-1997
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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 | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 016005409
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License Number State | IL
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