Individual
JEFFREY D MACKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
705 RILEY HOSPITAL DR, ROC 4270, INDIANAPOLIS, IN 46202-5109
(317) 274-7208
(317) 274-3442
Mailing address
PO BOX 719094, CHICAGO, IL 60677-9318
(317) 777-6435
(317) 777-6644
Taxonomy
Speciality
Code
Description
License number
State
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
01038187
IN
2080P0214X
Pediatric Pulmonology Physician
Primary
01038187
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000354896
ANTHEM-DEAC-350593390
—
05
—
100132000
—
IN
05
—
1011442
—
VT
05
—
1801844
—
LA
01
—
350593390-042
TRICARE-DEAC-350593390
—
05
—
3810016820
—
WV
05
—
64879174
—
KY
Enumeration date
08/30/2006
Last updated
03/06/2026
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