Organization
ST MARGARET MERCY HEALTHCARE CENTERS, INC.
Active
Other names
St Margaret Mercy Medical Associates OBGYN
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS GRYZBEK (PRESIDENT)
(219) 932-2300
Entity
Organization
Contact information
Practice address
5454 S HOHMAN AVE, HAMMOND, IN 46320-1931
(219) 933-2229
(219) 933-2614
Mailing address
PO BOX 1000, DYER, IN 46311-0800
(219) 864-2107
(219) 864-2251
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0090000854
BCBS GROUP NUMBER
IL
05
—
200159110P
—
IN
Enumeration date
11/15/2006
Last updated
01/05/2010
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