| Elkhart Clinic, Llc | |
|
6915 N Fir Rd Granger IN 46530-4754 | |
| (574) 296-3200 | |
| Not Available |
| Full Name | Elkhart Clinic, Llc |
|---|---|
| Speciality | Psychiatry & Neurology - Pain Medicine |
| Location | 6915 N Fir Rd, Granger, Indiana |
| Authorized Official Name and Position | Megan Leigh Carlson (CREDENTIALING) |
| Authorized Official Contact | 5742963991 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Elkhart Clinic, Llc Po Box 778985 Chicago IL 60677-8985 Ph: (574) 296-3990 | Elkhart Clinic, Llc 6915 N Fir Rd Granger IN 46530-4754 Ph: (574) 296-3200 |
| NPI Number | 1689440893 |
|---|---|
| Provider Enumeration Date | 11/29/2023 |
| Last Update Date | 11/29/2023 |
| Certification Date | 11/29/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689440893 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P2900X | Psychiatry & Neurology - Pain Medicine | (* (Not Available)) | Primary |
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