Paragon Clinical Midwest, Llc | |
8380 Virginia St Merrillville IN 46410 | |
(630) 832-1775 | |
Not Available |
Full Name | Paragon Clinical Midwest, Llc |
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Speciality | Nurse Practitioner |
Location | 8380 Virginia St, Merrillville, Indiana |
Authorized Official Name and Position | Marybeth Sutkowski (CHIEF MEDICAL OFFICER/PRINCIPAL) |
Authorized Official Contact | 6308321775 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Paragon Clinical Midwest, Llc Po Box 2477 Shelton CT 06484-1477 Ph: (630) 506-1245 | Paragon Clinical Midwest, Llc 8380 Virginia St Merrillville IN 46410 Ph: (630) 832-1775 |
NPI Number | 1619335700 |
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Provider Enumeration Date | 02/03/2016 |
Last Update Date | 09/20/2024 |
Medicare PECOS PAC ID | 2860791647 |
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Medicare Enrollment ID | O20160428001881 |
Identifier | Type | State | Issuer |
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1619335700 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Secondary |
363L00000X | Nurse Practitioner | (* (Not Available)) | Primary |
Provider Name | Marybeth E Sutkowski |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1447369293 PECOS PAC ID: 3476742024 Enrollment ID: I20151201000178 |
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