Basic Information
| Provider Information | |||||||||
| NPI: | 1114000999 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | VESKOVIC | ||||||||
| FirstName: | KATARINA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | |||||||||
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| Credential: | M.D. | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastName: | STOJANOVIC | ||||||||
| OtherFirstName: | KATARINA | ||||||||
| OtherMiddleName: | |||||||||
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| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 180 HARVESTER DR | ||||||||
| Address2: | SUITE 110 | ||||||||
| City: | BURR RIDGE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 605277594 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7737021061 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | GOTTCHALK MEDICAL PLAZA 1 MEDCAL PLAZA | ||||||||
| Address2: | |||||||||
| City: | IRVINE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 926971447 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9498248600 | ||||||||
| FaxNumber: | 9498241589 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/23/2006 | ||||||||
| LastUpdateDate: | 02/25/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/25/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 036117731 | IL | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.