| Doctor Name: | MARTIN KOVACHEVICH |
| NPI Number: | 1003855719 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | |
| Business Practice Address: | 2050 Pfingsten Rd Suite 330 Glenview, IL - 600261324 |
| Business Phone Number: | 8479984100 |
| Business Fax Number: | 8479988439 |
| Mailing Address: | 2650 Ridge Ave, Evanston Hospital Rm 1210 EVANSTON |
| State: | IL |
| Postal Code: | 602011718 |
| Phone Number: | 8475701206 |
| Fax Number: | 8475701248 |
| NPI Enumeration Date: | 06/06/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207QA0505X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Family Medicine |
| Taxonomy Specialization: | Adult Medicine |
| Taxonomy Definition: | |