# NEW BALANCE OCCUPATIONAL MEDICINE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1184921652
- **Authorized official:** ORANU G IBEKIE (MD)
- **Authorized official phone:** (219) 769-4400

## Contact information

- **Practice address:** 1574 E 85TH AVE, MERRILLVILLE, IN 46410
- **Practice address phone:** (219) 769-4400
- **Practice address fax:** (219) 795-1419
- **Mailing address:** PO BOX 10746, MERRILLVILLE, IN 46411-0746
- **Mailing address phone:** (219) 769-4400
- **Mailing address fax:** (219) 795-1419

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | IN | Yes |
| 207QA0401X | Addiction Medicine (Family Medicine) Physician | — | NULL | — |
| 207QA0401X | Addiction Medicine (Family Medicine) Physician | — | — | — |
| 2083X0100X | Occupational Medicine Physician | — | IN | — |

## Other

- **Enumeration date:** 02/18/2011
- **Last updated:** 04/24/2019