Mark Anthony Koludrovic in Evergreen Park - General Practice
Mark Anthony Koludrovic - NPI 1629146725
Mark Anthony Koludrovic is a General Practice in Evergreen Park, Illinois. Mark Anthony Koludrovic practices all healthcare services and medical treatments related to General Practice. The NPI Number for Mark Anthony Koludrovic is 1629146725. The last update date is 2007-07-08.
Mark Anthony Koludrovic's current location address is 9760 S Kedzie Ave Ste 4, Evergreen Park, Illinois. You can contact this provider via phone number 7084990379. The mailing address for Mark Anthony Koludrovic is 9760 S Kedzie Ave Ste 4, Evergreen Park, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Mark Anthony Koludrovic |
|---|---|
| Address | 9760 S Kedzie Ave Ste 4, Evergreen Park, Illinois |
| Phone Number | 7084990379 |
| Fax Number | |
| Sole Proprietor | Y |
| Credentials | DDS |
NPI Number Detail
| NPI Number | 1629146725 |
|---|---|
| Provider Enumeration Date | 2006-11-30 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 9760 S Kedzie Ave Ste 4 |
|---|---|
| City | Evergreen Park |
| State | Illinois (IL) |
| Post Code | 608053109 |
| Phone Number | 7084990379 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | General Practice |
|---|---|
| Taxonomy | 1223G0001X |
| Licence No | 19015134 |
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Definition: A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
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What is the unique 10-digit identifier code assigned to Mark Anthony Koludrovic by the Centers for Medicare & Medicaid Services?
The Mark Anthony Koludrovic has been issued the NPI (National Provider Identifier) 1629146725 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Where is the Mark Anthony Koludrovic located?
The Mark Anthony Koludrovic is located at 9760 S Kedzie Ave Ste 4, Evergreen Park, IL 608053109.
What is Mark Anthony Koludrovic's primary area of medical expertise, and what taxonomy classification code corresponds to this specialized field?
The primary area of medical expertise for Mark Anthony Koludrovic is General Practice, and the corresponding taxonomy classification code for this specialized field is 1223G0001X.
On what date did the Centers for Medicare & Medicaid Services issue the 1629146725 to Mark Anthony Koludrovic?
The Mark Anthony Koludrovic received its 1629146725 assignment from the Centers for Medicare & Medicaid Services on 2006-11-30.
As of what date was the information regarding Mark Anthony Koludrovic, such as address, specialty, and other details, last verified and confirmed to be up-to-date?
The information related to Mark Anthony Koludrovic, including its address, specialty, and other relevant details, was last verified and confirmed to be up-to-date on 2007-07-08.