Organization
MEDINA HEALTHCARE SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATIE A WERNER (CREDENTIALING)
(630) 261-9286
Entity
Organization
Contact information
Practice address
932 RICHARD RD, DYER, IN 46311-1936
(219) 515-2148
Mailing address
932 RICHARD RD, DYER, IN 46311-1936
(708) 982-1544
(219) 440-7312
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036089606
IL
Other
Enumeration date
06/18/2010
Last updated
12/05/2023
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