Physician Compare National (NPI:1538326426)

HEALTHCARE PROVIDER: IGOR DUKAREVICH D.P.M.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1538326426
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	3678745510
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20111018000852
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	DUKAREVICH
	Individual professional last name
Provider First Name	IGOR
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	2008
	Individual professional's medical school graduation year
Primary Specialty	PODIATRY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	175 E HAWTHORN PKWY
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 220
	Group Practice or individual's line 2 address
City	VERNON HILLS
	Group Practice or individual's city
State	IL
	Group Practice or individual's state
Zip Code	600611432
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	140049
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	WEST SUBURBAN MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	140083
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	LORETTO HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	140018
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	MT SINAI HOSPITAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 3
Professional Accepts Medicare Assignment	M