# CARDIOVASCULAR THORACIC ASSOCIATES OF LAKE COUNTY, P.C.

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

## Provider details

- **NPI number:** 1639133879
- **Authorized official:** DAVID JAYAKAR M.D. (PRESIDENT)
- **Authorized official phone:** (219) 836-2022

## Contact information

- **Practice address:** 4320 FIR ST, SUITE 210, EAST CHICAGO, IN 46312-3052
- **Practice address phone:** (219) 228-4776
- **Mailing address:** 9201 CALUMET AVE, MUNSTER, IN 46321-2807
- **Mailing address phone:** (219) 836-2022

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2086S0129X | Vascular Surgery Physician | — | NULL | — |
| 2086S0129X | Vascular Surgery Physician | — | — | — |
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | — | NULL | Yes |
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | — | — | Yes |

## Other

- **Enumeration date:** 04/14/2006
- **Last updated:** 03/18/2008