| NPI | 1215201868 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BEVERLY DELAO Administrator 219-836-5800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 01032154) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: IN 01052057) |
| 208000000X Pediatrics (Licence: IN 01061659) | |
| 208800000X Urology (Licence: IN 01066795) | |
| Enumeration Date | 2012-02-29 |
| Last Update Date | 2012-03-15 |