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NPI Code Detail

MEDICARE: OLYMPUS HEALTHCARE INC

MEDICARE: OLYMPUS HEALTHCARE INC
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
1208600000XSurgery Physician036052821IL

General Provider Information

NPI Number : 1417387069
Entity Type Code : Organization
Provider Name (Legal Business Name) : OLYMPUS HEALTHCARE INC
Provider Business Mailing Address
First Line : 1502 W CHICAGO AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60642-5236
Country : US
Telephone Number : 312-429-0254
Fax Number :
Provider Business Practice Location Address
First Line : 1502 W CHICAGO AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60642-5236
Country : US
Telephone Number : 312-429-0254
Fax Number :
Authorized Official
Title or Position : OWNER
Name : ZARIJA DJUROVIC
Credential : MD
Telephone Number : 312-429-0254
Provider Enumeration Date : 11/18/2013
Last Update Date : 04/14/2014

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Directions to “OLYMPUS HEALTHCARE INC ” Practice Location

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