| NPI | 1932575420 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONNA PHALEN Director 219-554-4548 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207KA0200X Allergy & Immunology, Allergy |
| 207NI0002X Dermatology, Clinical & Laboratory Dermatological Immunology | |
| 207Q00000X Family Medicine | |
| 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism | |
| 207RI0200X Internal Medicine, Infectious Disease | |
| 207RP1001X Internal Medicine, Pulmonary Disease | |
| 207RR0500X Internal Medicine, Rheumatology | |
| 207X00000X Orthopaedic Surgery | |
| 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery | |
| 208000000X Pediatrics | |
| 291U00000X Clinical Medical Laboratory | |
| Enumeration Date | 2015-08-19 |
| Last Update Date | 2021-09-21 |