MEDICARE: VESNA PIREC, LTD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician		IL

General Provider Information

NPI Number	:	1013085307
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VESNA PIREC, LTD

Provider Business Mailing Address
First Line	:	657 W BUENA AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60613-2589
Country	:	US
Telephone Number	:	773-627-8971
Fax Number	:	773-549-9692

Provider Business Practice Location Address
First Line	:	655 W IRVING PARK RD STE 206
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60613-4932
Country	:	US
Telephone Number	:	773-627-8971
Fax Number	:	773-549-9692

Authorized Official
Title or Position	:	PRESIDENT
Name	:	VESNA PIREC
Credential	:	MD, PHD
Telephone Number	:	773-627-8971

Provider Enumeration Date	:	12/03/2006
Last Update Date	:	08/22/2020

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