MEDICARE: VALENTINA DJORDJEVIC

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	363AM0700X	Medical Physician Assistant

General Provider Information

NPI Number	:	1750875407
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VALENTINA DJORDJEVIC

Provider Business Mailing Address
First Line	:	561 W DIVERSEY PKWY
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60614-6068
Country	:	US
Telephone Number	:	773-906-4546
Fax Number	:	773-304-4549

Provider Business Practice Location Address
First Line	:	561 W DIVERSEY PKWY
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60614-6068
Country	:	US
Telephone Number	:	773-906-4546
Fax Number	:	773-304-4549

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/17/2018
Last Update Date	:	03/16/2026

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Directions to “ VALENTINA DJORDJEVIC ” Practice Location

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