Individual
DR. JAY L. KORACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7905 CALUMET, HAMMOND CLINIC LLC, MUNSTER, IN 46321-1215
(219) 836-5800
(219) 836-8073
Mailing address
7905 CALUMET, MUNSTER, IN 46321-1215
(414) 455-4780
(414) 475-2936
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
01062709
IN
2085R0202X
Diagnostic Radiology Physician
036085791
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036085791
—
IL
05
—
200863860
—
IN
Enumeration date
12/28/2005
Last updated
10/28/2014
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