Individual
MITCHELL L BRESSACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
70 W 94TH PLACE, CROWN POINT, IN 46307-1710
(219) 662-8822
(219) 662-8833
Mailing address
70 W 94TH PLACE, CROWN POINT, IN 46307-1710
(219) 662-8822
(219) 662-8833
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
01031629
IN
207N00000X
Dermatology Physician
036059363
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100214910A
—
IN
Enumeration date
06/16/2005
Last updated
05/04/2023
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