Doctor Name: | GEORGE ILIJA SRECKOVIC |
NPI Number: | 1629067038 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 036095069 |
Business Practice Address: | 15300 West Ave Suite 314 West Orland Park, IL - 604624600 |
Business Phone Number: | 7083647882 |
Business Fax Number: | 7083647886 |
Mailing Address: | 10400 Southwest Hwy, Ll CHICAGO RIDGE |
State: | IL |
Postal Code: | 604151367 |
Phone Number: | 7085817308 |
Fax Number: | 7082744027 |
NPI Enumeration Date: | 10/18/2005 |
NPI Last Update Date: | 02/17/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 036095069 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |