Organization
PRACTICE SERVICES OF INDIANA PC
Active
Organization
PRACTICE SERVICES OF INDIANA PC
Active
Parent organization
OAK STREET HEALTH MSO LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
OAK STREET HEALTH MSO LLC
Authorized official
GRIFFIN MYERS M.D., M.B.A. (PRESIDENT/CHIEF MEDICAL OFFICER)
(312) 600-8484
Entity
Organization
Contact information
Practice address
6401 E WASHINGTON ST, INDIANAPOLIS, IN 46219-6614
(312) 733-9730
(312) 866-8014
Mailing address
213 N RACINE AVE, 100, CHICAGO, IL 60607-1644
(312) 733-9730
(312) 866-8014
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
05/11/2016
Last updated
05/11/2016
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