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General NPI Number Information
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NPI Number | 1861686388
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Entity Type | Organization
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Legal Business Name | SLOBODAN D. VUCICEVIC,MD, SC
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Dates
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Enumeration Date | 08/28/2007
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 3825 HIGHLAND AVE SUITE 3C
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City | DOWNERS GROVE
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State | IL
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Zip | 60515-1552
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Country | US
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Telephone | 708-749-0117
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Fax | 708-749-8593
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Provider Business Mailing Address
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Address Line | 3501 S HARLEM AVE
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City | BERWYN
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State | IL
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Zip | 60402-3263
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Country | US
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Telephone | 708-749-0117
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Fax | 708-749-8593
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SLOBODAN D VUCICEVIC
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Credential | M.D.
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Telephone | 708-749-0117
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State | IL
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