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Contact Information

NIKOLA IVANCEVIC, DPM
5646 ST CHARLES RD
SUITE B
BERKELEY, IL60163
 Phone: 630-782-6557
 Fax: 630-782-6559
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Surgery, Foot

213ES0131X 48 Podiatry
Indicates primary specialty

NPI Profile & details for NIKOLA IVANCEVIC · (Male)

NPI # 1972685410
Status Active
Credentials DPM (Doctor of Podiatric Medicine)
Entity Individual
Enumeration date 10/20/2006
Last updated 11/04/2016 - About 10 years ago
Sole proprietor 1 Yes
Identifiers
  • IL License # 016-004831
  • IL Medicaid 016-004831
Hospital affiliation(s) Not Available
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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