B JERCINOVIC PEDIATRICS LTD NPI 1851519888

NPI Information

NPI: 1851519888
Provider Name: B JERCINOVIC PEDIATRICS LTD
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

CLIA Number: 14D0670343

Address:
807 W JEFFERSON ST UNIT Q
SHOREWOOD, IL
ZIP 60404
Phone: (815) 729-1144
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B JERCINOVIC PEDIATRICS LTD is a primary care clinic center in Shorewood, IL. B JERCINOVIC PEDIATRICS LTD NPI is 1851519888. The provider is registered as an organization entity type.

The provider's business location address is:

807 W JEFFERSON ST UNIT Q
SHOREWOOD, IL
ZIP 60404-301
Phone: (815) 729-1144
Fax: (815) 729-1157

The provider's authorized official is Bruno J Jercinovic .
The authorized official title is President and has the following contact phone number (815) 729-1144.

The CLIA number assigned to this NPI record is 14D0670343 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/23/2007 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QP2300X	Clinic/Center	Primary Care		ILLINOIS	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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