Ms Chantal L Walker, MD | |
1225 E Coolspring Ave Ste 1c, Michigan City, IN 46360-6312 | |
(219) 861-5719 | |
(219) 861-5774 |
Full Name | Ms Chantal L Walker |
---|---|
Gender | Female |
Speciality | Pediatrics |
Location | 1225 E Coolspring Ave Ste 1c, Michigan City, Indiana |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1508979725 | NPI | - | NPPES |
200280630 | Medicaid | IN | |
000000198778 | Other | IN | ANTHEM PROVIDER ID NO. |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | 01052190A (Indiana) | Primary |
Entity Name | Northshore Health Centers Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1114257300 PECOS PAC ID: 5799671236 Enrollment ID: O20040827000220 |
Entity Name | Franciscan Physician Network |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1225327984 PECOS PAC ID: 3072790682 Enrollment ID: O20110608000486 |
Entity Name | Edgewater Systems For Balanced Living Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1588705784 PECOS PAC ID: 9234398397 Enrollment ID: O20120308000405 |
Entity Name | Community Care Network Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1457610487 PECOS PAC ID: 3678737012 Enrollment ID: O20120614000331 |
Mailing Address | Practice Location Address |
---|---|
Ms Chantal L Walker, MD Po Box 781076, Detroit, MI 48278-1076 Ph: (317) 528-4800 | Ms Chantal L Walker, MD 1225 E Coolspring Ave Ste 1c, Michigan City, IN 46360-6312 Ph: (219) 861-5719 |
Dr. Courtney Elizabeth Glos, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 200 Alfred St, Michigan City, IN 46360 Phone: 219-872-6200 Fax: 219-879-2915 | |
Jagjeevan Rao Gandra, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 3723 Franklin St, Michigan City, IN 46360 Phone: 219-874-3313 Fax: 219-878-2330 | |
Yoo Paik, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1225 E Coolspring Ave, Michigan City, IN 46360 Phone: 219-878-5036 Fax: 219-873-2931 | |
Gregoria B Landicho, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1501 Wabash, Suite #202, Michigan City, IN 46360 Phone: 219-877-1965 Fax: 219-877-1066 | |
Mark Jacobi, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1225 E Coolspring Ave, Michigan City, IN 46360 Phone: 219-878-5037 Fax: 219-873-2931 | |
Razia Begum, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 710 Franklin St, Michigan City, IN 46360 Phone: 219-872-6200 Fax: 219-879-2915 |