Amalia Maria Prodanovic

Physician Assistant · Lake Forest, IL

Individual Active NPI

NPI number 1396235792

Practice location

1000 N Westmoreland Rd
Lake Forest, IL 60045
Phone
(847) 234-5600

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NPI record

NPI
1396235792
Entity type
Individual (Type 1)
Enumeration date
May 11, 2018
Last updated
November 6, 2025
Certified
November 6, 2025
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Physician Assistant Primary 363A00000X 08500646 IL
Physician Assistant 363A00000X — —
Student in an Organized Health Care Education/Training Program 390200000X — —

Mailing address

714 S Hamlin Ave
Park Ridge, IL 60068-4314
Phone
(847) 337-9960

About Amalia Prodanovic

Amalia Maria Prodanovic is a healthcare provider registered in the NPI registry with the primary taxonomy Physician Assistant (code 363A00000X). The practice location is 1000 N Westmoreland Rd, Lake Forest, IL 60045. The NPI number 1396235792 was assigned on May 11, 2018 and the record was last updated on November 6, 2025.

Amalia Prodanovic lists a license in the registry: #08500646 (IL) for Physician Assistant. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Amalia Maria Prodanovic?

The NPI number is 1396235792.

What is the phone number of Amalia Prodanovic?

The phone number listed for the practice location is (847) 234-5600.

Where is Amalia Prodanovic located?

1000 N Westmoreland Rd, Lake Forest, IL 60045.

What is the taxonomy code for Amalia Prodanovic?

The primary taxonomy code is 363A00000X – Physician Assistant; 2 more listed above.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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