Organization
NORTHSHORE HEALTH CENTERS, INC.
Active
Other names
NorthShore River Forest High School Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID HALL (CEO)
(219) 763-8112
Entity
Organization
Contact information
Practice address
3300 INDIANA ST RM 1, HOBART, IN 46342-1061
(219) 763-8112
Mailing address
PO BOX 1430, PORTAGE, IN 46368-9230
(219) 763-8112
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
09/22/2021
Last updated
09/22/2021
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