Organization
219 HEALTH NETWORK, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM CORTES (EXECUTIVE DIRECTOR)
(219) 703-2585
Entity
Organization
Contact information
Practice address
10215 BROADWAY STE 204, CROWN POINT, IN 46307-8001
(219) 661-6152
(219) 703-6833
Mailing address
100 W CHICAGO AVE STE F, EAST CHICAGO, IN 46312-3261
(219) 392-7016
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
08/08/2023
Last updated
08/16/2024
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