Provider Demographics
NPI:1558140905
Name:BULATOVIC, MARIJA J (DNP, MSN)
Entity type:Individual
Prefix:
First Name:MARIJA
Middle Name:J
Last Name:BULATOVIC
Suffix:
Gender:F
Credentials:DNP, MSN
Other - Prefix:
Other - First Name:MARIJA
Other - Middle Name:J
Other - Last Name:PROJCESKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1100 E RANDVILLE DR UNIT 201
Mailing Address - Street 2:
Mailing Address - City:PALATINE
Mailing Address - State:IL
Mailing Address - Zip Code:60074-2915
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:233 S GARY AVE
Practice Address - Street 2:
Practice Address - City:BLOOMINGDALE
Practice Address - State:IL
Practice Address - Zip Code:60108-2213
Practice Address - Country:US
Practice Address - Phone:630-208-6775
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-25
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209028845363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner