MEDICARE: JASMINKA KOSTIC, M.D.,S.C.

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	174400000X	Specialist		IL

General Provider Information

NPI Number	:	1033315338
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JASMINKA KOSTIC, M.D.,S.C.

Provider Business Mailing Address
First Line	:	3114 W IRVING PARK RD
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60618-3406
Country	:	US
Telephone Number	:	773-588-6680
Fax Number	:	773-588-6451

Provider Business Practice Location Address
First Line	:	3114 W IRVING PARK RD
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60618-3406
Country	:	US
Telephone Number	:	773-588-6680
Fax Number	:	773-588-6451

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MISS KATHY MILANOVIC
Credential	:
Telephone Number	:	773-588-6680

Provider Enumeration Date	:	06/23/2007
Last Update Date	:	08/22/2020

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