Provider Demographics
NPI:1912793019
Name:MARKOVIC MEDICAL INC
Entity type:Organization
Organization Name:MARKOVIC MEDICAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JELENA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARKOVIC
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:585-287-7535
Mailing Address - Street 1:120 S GROVE AVE APT 2A
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60302-2831
Mailing Address - Country:US
Mailing Address - Phone:585-287-7535
Mailing Address - Fax:630-277-9837
Practice Address - Street 1:120 S GROVE AVE APT 2A
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60302-2831
Practice Address - Country:US
Practice Address - Phone:585-287-7535
Practice Address - Fax:630-277-9837
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-16
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036137769OtherILLINOIS MEDICAL LICENSE NUMBER