Boskovich Tasic, Dana

Boskovich Tasic, Dana is an individual health care provider with primary practice located at 2650 Ridge Ave , Evanston IL 60201-1718. She recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Anesthesiology. Other Service Providers / Specialist is her primary health care specialty. Boskovich Tasic, Dana can be contacted via phone (847) 570-2760.

Contact Information

Primary practice address
2650 Ridge Ave Evanston IL 60201-1718
Phone: (847) 570-2760
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 01060162A Indiana
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X 01060162A Indiana
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X 036141385 Illinois

Profile Details

NPI number 1295783595
LBN Legal business name Boskovich Tasic, Dana
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 5th, 2006
Last updated May 11th, 2017 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1295783595 NPPES
Indiana MEDICAID 200531900A
Indiana Other 000000371979

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