| NPI | 1093213506 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM CORTES Executive Director 219-703-2585 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 207V00000X Obstetrics & Gynecology | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| 261QD0000X Clinic/Center, Dental | |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2018-01-30 |
| Last Update Date | 2024-08-16 |