Organization
ST MARGARET MERCY HEALTHCARE CENTERS
Active
Other names
Midwest Bariatric Institute@ Saint Margaret Mercy
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS GRYZBEK (PRESIDENT)
(219) 932-2300
Entity
Organization
Contact information
Practice address
24 JOLIET ST, UNIT 302, DYER, IN 46311-1705
(219) 852-2518
(219) 864-2156
Mailing address
PO BOX 1000, DYER, IN 46311-0800
(219) 864-2107
(219) 864-2251
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
90000854
BCBC
IL
Enumeration date
11/15/2006
Last updated
11/23/2009
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