Organization
GRACIELA E. HERNANDEZ MEDICAL CORPORATION P C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GRACIELA E HERNANDEZ MD (PRESIDENT)
(219) 937-2929
Entity
Organization
Contact information
Practice address
4320 FIR STREET, EAST CHICAGO, IN 46312-3076
(219) 397-2929
(219) 397-2929
Mailing address
4320 FIR STREET, EAST CHICAGO, IN 46312-3076
(219) 397-2929
(219) 397-2929
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
011029949
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100213510A
—
IN
Enumeration date
12/10/2010
Last updated
06/01/2015
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