Provider Demographics
NPI:1356523898
Name:TOMIC, DRAGANA (MD)
Entity type:Individual
Prefix:DR
First Name:DRAGANA
Middle Name:
Last Name:TOMIC
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4405 WEAVER PKWY
Mailing Address - Street 2:
Mailing Address - City:WARRENVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60555-3269
Mailing Address - Country:US
Mailing Address - Phone:630-352-5300
Mailing Address - Fax:630-352-5499
Practice Address - Street 1:4405 WEAVER PKWY
Practice Address - Street 2:
Practice Address - City:WARRENVILLE
Practice Address - State:IL
Practice Address - Zip Code:60555-3269
Practice Address - Country:US
Practice Address - Phone:630-352-5300
Practice Address - Fax:630-352-5499
Is Sole Proprietor?:No
Enumeration Date:2007-11-27
Last Update Date:2013-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036131086207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036131086Medicaid
IL206147138OtherMEDICARE PTAN (INDIVIDUAL)
ILP01144163OtherRAILROAD MEDICARE INDIVIDUAL PTAN
IL206147OtherMEDICARE PTAN (GROUP)