Provider Demographics
NPI:1225824311
Name:TADIC, BOJANA (APRN, CNP)
Entity type:Individual
Prefix:
First Name:BOJANA
Middle Name:
Last Name:TADIC
Suffix:
Gender:F
Credentials:APRN, CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:233 S GARY AVE
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60108-2213
Mailing Address - Country:US
Mailing Address - Phone:630-924-4009
Mailing Address - Fax:630-924-9671
Practice Address - Street 1:233 S GARY AVE
Practice Address - Street 2:
Practice Address - City:BLOOMINGDALE
Practice Address - State:IL
Practice Address - Zip Code:60108-2213
Practice Address - Country:US
Practice Address - Phone:630-924-4009
Practice Address - Fax:630-924-9671
Is Sole Proprietor?:No
Enumeration Date:2025-04-16
Last Update Date:2025-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209033173363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner