Organization
ICEM, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CAROL KARP (AUTHORIZED REPRESENTATIVE)
(317) 278-3522
Entity
Organization
Contact information
Practice address
340 W 10TH ST, INDIANAPOLIS, IN 46202-3082
(317) 278-3500
(317) 870-0499
Mailing address
5446 RELIABLE PKWY, CHICAGO, IL 60686-0001
(317) 472-7317
(317) 962-4903
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200983590
—
IN
Enumeration date
10/29/2009
Last updated
06/14/2011
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