DR. NIKOLA IVANCEVIC (NPI# 1972685410) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972685410 |
| Entity Type | Individual |
| Full Name | DR. NIKOLA IVANCEVIC |
| Credential | DPM |
| Practice Address |
5646 St Charles Rd Suite B Berkeley IL 60163 |
| Practice Telephone | 6307826557 |
| Practice Fax Number | 6307826559 |
| Mailing Telephone | 6307826557 |
| Mailing Fax Number | 6307826559 |
| Enumeration Date | 2006-10-20 |
| Last Update Date | 2016-11-04 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213ES0131X |
Podiatrist Specialization: Foot Surgery |
016-004831 | IL | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 016-004831 | 05 |
| Street Address |
5646 ST CHARLES RD SUITE B |
| City | BERKELEY |
| State | IL |
| Zip Code | 60163 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194720292 | New Home Respiratory Care, Inc | Durable Medical Equipment & Medical Supplies | 5813 Saint Charles Rd, Berkeley, IL 60163-1031 | 2005-06-15 |
| 1972856839 | Kathleen Anne Ruffulo | Counselor | 1212 N Ashbel Ave, Berkeley, IL 60163-1118 | 2012-10-16 |
| 1104197664 | Nadia C Hughes | Pharmacist | 1228 N Irving Ave, Berkeley, IL 60163-1130 | 2012-01-14 |
| 1649294927 | Gary Robert Johnson | Dentist | 5646 Saint Charles Rd, Suite C, Berkeley, IL 60163-1148 | 2006-07-27 |
| 1386095933 | Michael A. Esposito Dds, P.C. | Dentist | 5646 Saint Charles Rd, Suite C, Berkeley, IL 60163-1148 | 2016-06-24 |
| 1144663139 | Clinical Research Institute, Inc. | Voluntary or Charitable | 5646 Saint Charles Rd, Suite C, Berkeley, IL 60163-1148 | 2013-04-10 |
| 1063573277 | Michael Anthony Esposito | Dentist | 5646 Saint Charles Rd, Suite C, Berkeley, IL 60163-1148 | 2006-12-12 |
| 1366466930 | Gary R. Johnson, D.d.s., P.C. | Clinic/Center | 5646 Saint Charles Rd, Suite C, Berkeley, IL 60163-1148 | 2006-07-27 |
| 1861517617 | Berkeley School Dist 87 | Local Education Agency (LEA) | 5400 Saint Charles Rd, Berkeley, IL 60163-1244 | 2007-03-20 |
| 1922612613 | Mia Violetta Karoutsos | Massage Therapist | 5920 Burr Oak Ave, Berkeley, IL 60163-1425 | 2020-09-01 |
| Find all providers in zip 60163 | ||||
| Taxonomy Code | 213ES0131X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Foot Surgery |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902269301 | Jillian Cabai | Podiatrist | 3000 N Halsted St Ste 606, Chicago, IL 60657-6456 | 2016-04-01 |
| 1710279641 | Prpodiatry, LLC | Podiatrist | 433 W Briar Pl, Unit 7b, Chicago, IL 60657-4752 | 2011-05-11 |
| 1205071149 | Bradley W. Buckrop Dpm | Podiatrist | 3727 46th Ave, Suite 103, Rock Island, IL 61201-7078 | 2008-12-05 |
| 1396919130 | Marwa Sayed | Podiatrist | 7255 W 87th St Unit 1, Bridgeview, IL 60455-1821 | 2008-04-14 |
| 1013191287 | Nikola Ivancevic Dpm PC | Podiatrist | 135 S Palmer Dr, Suite 105, Elmhurst, IL 60126-3403 | 2007-12-24 |
| 1659577575 | Pam Eernisse Dpm Sc | Podiatrist | 680 N Lake Shore Dr # 1305, Chicago, IL 60611-4546 | 2007-06-26 |
| 1720118367 | Larry Allen Keyes | Podiatrist | 1023 Madison St, Oak Park, IL 60302-4404 | 2007-03-06 |
| 1548399462 | Two Steps Ahead Podiatry, Inc. | Podiatrist | 1001 E Wilson St Ste 180, Batavia, IL 60510-3168 | 2007-03-05 |
| 1447392972 | Willie Lee Brown | Podiatrist | 10700 Lincoln Trl, Suite E, Fairview Heights, IL 62208-2037 | 2007-02-12 |
| 1205868551 | Angela Pezzuto | Podiatrist | 1424 E. 53rd St., Ste.301, Mitchell Foot and Ankle, Chicago, IL 60615 | 2006-07-07 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.