Organization
INDIGO PARTNERS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY TILAK (MD)
(219) 267-1799
Entity
Organization
Contact information
Practice address
9410 CALUMET AVE, SUITE 201, MUNSTER, IN 46321
(219) 267-1799
Mailing address
PO BOX 3354, MUNSTER, IN 46321-0354
(219) 267-1799
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
207RP1001X
Pulmonary Disease Physician
Primary
—
—
Other
Enumeration date
01/04/2023
Last updated
02/20/2024
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