# ST MARGARET MERCY HEALTHCARE CENTERS

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Urosurgery Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1588850259
- **Authorized official:** THOMAS GRYZBEK (PRESIDENT)
- **Authorized official phone:** (219) 932-2300

## Contact information

- **Practice address:** 5454 HOHMAN AVE, 1 FLOOR C, HAMMOND, IN 46320-1931
- **Practice address phone:** (219) 932-5576
- **Practice address fax:** (219) 933-2655
- **Mailing address:** PO BOX 1000, DYER, IN 46311-0800
- **Mailing address phone:** (219) 864-2107
- **Mailing address fax:** (219) 864-2251

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208800000X | Urology Physician | — | NULL | Yes |
| 208800000X | Urology Physician | — | — | Yes |

## Other

- **Enumeration date:** 09/17/2007
- **Last updated:** 02/04/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 200159110O | — | IN |
| 01 | — | 90000854 | BCBS | IL |