DEJAN MAKSIMOVIC DO NPI 1891992269

Family Medicine in Peoria, IL

About DEJAN MAKSIMOVIC

Dejan Maksimovic is a provider in Peoria, IL with more than 11 years of experience. The NPI number assigned to this provider is 1891992269. The practitioner's primary taxonomy code is Family Medicine (207Q00000X). The provider is registered as an individual and their NPI record was last updated 3 years ago. Dejan Maksimovic is registered with Medicare and accepts claims assignment.

NPI1891992269 Additional informationCallout TooltipNational Provider Indentifier (NPI)
The 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.
Provider Name DEJAN MAKSIMOVIC DO
Provider Location Address5114 N GLEN PARK PLACE RD PEORIA, IL 61614 Additional informationCallout TooltipProvider location address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Mailing Address5114 N GLEN PARK PLACE RD PEORIA, IL 61614 Additional informationCallout TooltipProvider mailing address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.
GenderMale
NPI Entity TypeIndividual Additional informationCallout TooltipEntity type code
The code describing the type of health care provider that is being assigned an NPI.
Codes are:
1 = (Person): individual human being who furnishes health care;
2 = (Non-person): entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO).
Medical School NameOTHER
Graduation Year2007
Is Sole Proprietor?No
Is Organization Subpart?N/A Additional informationCallout TooltipWhat is a subpart?
Subparts are the components and separate physical locations of organization health care providers. Examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.
Enumeration Date06-29-2007 Additional informationCallout TooltipProvider enumeration date
The date the provider was assigned a unique identifier (assigned an NPI)
Last Update Date10-06-2014 Additional informationCallout TooltipLast update date
The date that a record was last updated or changed.

Business Address

DEJAN MAKSIMOVIC DO
5114 N GLEN PARK PLACE RD
PEORIA, IL
ZIP 61614
Phone: (309) 655-2431
Fax: (309) 683-2412
Get Directions

Mailing Address

DEJAN MAKSIMOVIC DO
5114 N GLEN PARK PLACE RD
PEORIA, IL
ZIP 61614
Phone: (309) 655-2431
Fax: (309) 683-2412

Primary Taxonomy

Taxonomy Code207Q00000X Additional informationCallout TooltipPrimary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
ClassificationFamily Medicine
TypeAllopathic & Osteopathic Physicians
License No.036124188
License StateIL
Taxonomy DescriptionFamily Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Secondary Taxonomies


The secondary taxonomy codes define the provider type, classification, and specialization. For individual NPIs the license data is associated to each taxonomy code.

No. Taxonomy Code Type Classification Specialization License No. State Primary
1207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine56981WINo

Taxonomy Description: family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
809840OTHER (01)IL
809840038OTHER (01)IL

Map Location


DEJAN MAKSIMOVIC DO address is 5114 N GLEN PARK PLACE RD PEORIA, IL 61614

Other Providers at the same location


The following 20 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1205876166 JANE KALMES P.A.
Individual
Physician Assistant (Medical)5114 N GLEN PARK PLACE RD
PEORIA, IL 61614
(309) 683-6600
1235229535 TERRYL A. POLANIN
Individual
Nurse Practitioner5114 N GLEN PARK PLACE RD
PEORIA, IL 61614
(309) 683-5600
1275557498DR. WADE CARLSON MD
Individual
Family Medicine5114 N GLEN PARK PLACE RD
PEORIA, IL 61614
(309) 683-6600
1356535645MRS. KAREN A COLLINS APN
Individual
Nurse Practitioner (Obstetrics & Gynecology)5114 N GLEN PARK PLACE RD SUITE #220
PEORIA, IL 61614
(309) 692-2025
1457634693 MEROPI IOANNOU LANGLEY CNP-BC
Individual
Nurse Practitioner5114 N GLEN PARK PLACE RD
PEORIA, IL 61614
(309) 683-8108
1477533057 SUSAN SPHAR CNM
Individual
Midwife5114 N GLEN PARK PLACE RD SUITE 220
PEORIA, IL 61614
(309) 692-2025
1548424948MRS. LINDA S VALENTE NP
Individual
Nurse Practitioner (Family)5114 N GLEN PARK PLACE RD
PEORIA, IL 61614
(309) 683-8108
1558641662MRS. MEGAN MARIE KESLER APN, NP-C
Individual
Nurse Practitioner (Family)5114 N GLEN PARK PLACE RD
PEORIA, IL 61614
(309) 683-5600
1598062689 STEPHANIE C MEUSER APN
Individual
Nurse Practitioner5114 N GLEN PARK PLACE RD
PEORIA, IL 61614
(309) 683-6600
1649488925DR. CRAIG LOUIS-ALBERT HIGGS M.D.
Individual
Pediatrics5114 N GLEN PARK PLACE RD
PEORIA, IL 61614
(309) 683-5600
1659525855 HOPE PLACHER PA-C
Individual
Physician Assistant5114 N GLEN PARK PLACE RD
PEORIA, IL 61614
(309) 683-2401
1679630156DR. PATRICIO LUIS ILADA IV M.D.
Individual
Family Medicine5114 N GLEN PARK PLACE RD
PEORIA, IL 61614
(309) 683-6600
1700899788 DONALD R. WALLACE M.D.
Individual
Emergency Medicine5114 N GLEN PARK PLACE RD
PEORIA, IL 61614
(309) 683-6600
1790922599 ELIZABETH A OBJARTEL NP
Individual
Nurse Practitioner5114 N GLEN PARK PLACE RD
PEORIA, IL 61614
(309) 683-8108
1861582165 TERRY SMITH
Individual
5114 N GLEN PARK PLACE RD
PEORIA, IL 61614
(309) 683-5600
1871754309DR. ANNE CATHERINE RISK M.D.
Individual
Internal Medicine5114 N GLEN PARK PLACE RD
PEORIA, IL 61614
(309) 683-5600
1881966455 MEGAN R SCHMIDT APN
Individual
Nurse Practitioner5114 N GLEN PARK PLACE RD
PEORIA, IL 61614
(309) 683-6600
1891885182 RANDOLPH MCCREA
Individual
5114 N GLEN PARK PLACE RD
PEORIA, IL 61614
(309) 683-5600
1891885190 BARRY MILLER
Individual
5114 N GLEN PARK PLACE RD
PEORIA, IL 61614
(309) 683-5600
1891922571DR. MARY ELIZABETH STAPEL M.D.
Individual
Internal Medicine5114 N GLEN PARK PLACE RD DEPT OF COMBINED INTERNAL MEDICINE-PEDIATRICS
PEORIA, IL 61614
(309) 683-5600