Provider Demographics
NPI:1588959662
Name:JOVANOVICH, ALEXANDAR (MD)
Entity type:Individual
Prefix:DR
First Name:ALEXANDAR
Middle Name:
Last Name:JOVANOVICH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:ALEX
Other - Middle Name:
Other - Last Name:JOVANOVICH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:355 N CANAL ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60606-1207
Mailing Address - Country:US
Mailing Address - Phone:847-757-2376
Mailing Address - Fax:847-881-0822
Practice Address - Street 1:355 N CANAL ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60606-1207
Practice Address - Country:US
Practice Address - Phone:847-757-2376
Practice Address - Fax:847-881-0822
Is Sole Proprietor?:No
Enumeration Date:2011-06-16
Last Update Date:2018-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036136320207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine