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General NPI Number Information
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NPI Number | 1609751882
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Entity Type | Individual
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Provider Name | SANJA STOJAKOVIC APRN
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Gender | Female
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Dates
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Enumeration Date | 08/07/2025
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Last Update Date | 08/07/2025
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Provider Practice Location Address
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Address Line | 3298 RESOURCE PKWY
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City | DEKALB
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State | IL
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Zip | 60115-5331
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Country | US
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Telephone | 815-756-5526
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Fax |
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Provider Business Mailing Address
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Address Line | 41800 W 11 MILE RD STE 109
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City | NOVI
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State | MI
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Zip | 48375-1818
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Country | US
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Telephone | 248-669-6160
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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 | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 209.032459
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License Number State | IL
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