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General NPI Number Information
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NPI Number | 1659631844
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Entity Type | Organization
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Legal Business Name | JOSIP PASIC MD SC
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Dates
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Enumeration Date | 05/21/2012
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Last Update Date | 07/07/2012
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Provider Practice Location Address
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Address Line | 5510 N SHERIDAN RD APT. 7A
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City | CHICAGO
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State | IL
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Zip | 60640-1633
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Country | US
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Telephone | 773-728-6805
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Fax |
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Provider Business Mailing Address
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Address Line | 5510 N SHERIDAN RD APT. 7A
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City | CHICAGO
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State | IL
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Zip | 60640-1633
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Country | US
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Telephone | 773-728-6805
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JOSIP PASIC
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Credential | MD
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Telephone | 773-728-6805
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 036050621
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License Number State | IL
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