Excellent Neurology Service | |
255 E 90th Dr Merrillville IN 46410-8144 | |
(609) 933-3687 | |
Not Available |
Full Name | Excellent Neurology Service |
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Speciality | Psychiatry & Neurology |
Location | 255 E 90th Dr, Merrillville, Indiana |
Authorized Official Name and Position | Cheng Du (CEO) |
Authorized Official Contact | 6099333687 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Excellent Neurology Service 3211 Humboldt St West Lafayette IN 47906-7224 Ph: (609) 933-3687 | Excellent Neurology Service 255 E 90th Dr Merrillville IN 46410-8144 Ph: (609) 933-3687 |
NPI Number | 1417582552 |
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Provider Enumeration Date | 03/09/2020 |
Last Update Date | 07/05/2020 |
Certification Date | 07/05/2020 |
Medicare PECOS PAC ID | 8921429960 |
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Medicare Enrollment ID | O20200601000183 |
Identifier | Type | State | Issuer |
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1417582552 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
Provider Name | Reba J Mahaffey |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1215072715 PECOS PAC ID: 3375519614 Enrollment ID: I20040908000492 |
Provider Name | Cheng Du |
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Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1245209246 PECOS PAC ID: 2668491168 Enrollment ID: I20051114001121 |
Provider Name | Vicki Lynn Lederle |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1508454778 PECOS PAC ID: 9931344777 Enrollment ID: I20210226000987 |
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