Basic Information
Provider Information
NPI: 1164942066
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DOKIC
FirstName: DANIJELA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2650 RIDGE AVE.
Address2: IM HOSPITALISTS STE 4210
City: EVANSTON
State: IL
PostalCode: 60201
CountryCode: US
TelephoneNumber: 8475701010
FaxNumber: 8477335108
Practice Location
Address1: 2650 RIDGE AVE.
Address2: IM HOSPITALISTS STE 4210
City: EVANSTON
State: IL
PostalCode: 60201
CountryCode: US
TelephoneNumber: 8475701010
FaxNumber: 8477335108
Other Information
ProviderEnumerationDate: 06/21/2017
LastUpdateDate: 08/06/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/06/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208M00000X036152095ILY Allopathic & Osteopathic PhysiciansHospitalist 
207R00000X036152095ILN Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


Home