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Contact Information

AMALIA M PRODANOVIC
1000 N WESTMORELAND RD
LAKE FOREST, IL60045
 Phone: 847-234-5600
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physician Assistant

363A00000X 97 Physician Assistant
 

Student in an Organized Health Care Education/Training Program

390200000X
Indicates primary specialty

NPI Profile & details for AMALIA M PRODANOVIC · (Female)

NPI Number 1396235792
Status Active
Credentials
Entity Individual
Enumeration date 05/11/2018
Last updated 11/06/2025 - About 7 months ago
Sole proprietor 1 No
Identifiers
  • IL License # 08500646
Hospital affiliation(s)
  • LAKE FOREST HOSPITAL - (Acute Care)
    660 N WESTMORELAND ROAD
    LAKE FOREST, IL 60045
  • NORTHWESTERN MEMORIAL HOSPITAL - (Acute Care)
    251 E HURON ST
    CHICAGO, IL 60611
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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