| NPI | 1457542292 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NAZEERULLA SHAIK Head Md 219-838-0066 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2007-08-07 |
| Last Update Date | 2014-10-23 |