Munster Primary Care Pc | |
9731 Prairie Ave Highland IN 46322-3616 | |
(219) 301-5212 | |
(708) 221-6766 |
Full Name | Munster Primary Care Pc |
---|---|
Speciality | Internal Medicine |
Location | 9731 Prairie Ave, Highland, Indiana |
Authorized Official Name and Position | Asif H Farooqui (PRESIDENT) |
Authorized Official Contact | 9016195629 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Munster Primary Care Pc Po Box 5580 Villa Park IL 60181-5305 Ph: (708) 478-7201 | Munster Primary Care Pc 9731 Prairie Ave Highland IN 46322-3616 Ph: (219) 301-5212 |
NPI Number | 1659749489 |
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Provider Enumeration Date | 09/10/2015 |
Last Update Date | 12/27/2015 |
Medicare PECOS PAC ID | 7012225022 |
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Medicare Enrollment ID | O20150924001483 |
Identifier | Type | State | Issuer |
---|---|---|---|
1659749489 | NPI | - | NPPES |
01063801A | Other | IN | LICENSE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | 01063801A (Indiana) | Primary |
Provider Name | Asif H Farooqui |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1902865421 PECOS PAC ID: 8426074071 Enrollment ID: I20080807000130 |
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