Organization
DR MARY TILAK PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY N. TILAK M.D. (PRESIDENT)
(219) 922-8051
Entity
Organization
Contact information
Practice address
9410 CALUMET AVE STE 101, MUNSTER, IN 46321-2812
(219) 922-8051
(219) 922-8608
Mailing address
PO BOX 736895, CHICAGO, IL 60673-6895
(219) 922-8051
(219) 922-8608
Taxonomy
Speciality
Code
Description
License number
State
207RB0002X
Obesity Medicine (Internal Medicine) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000541656
ANTHEM
IN
01
—
90001352
BC/BS
IL
Enumeration date
11/07/2007
Last updated
04/24/2026
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