Organization
ST MARGARET MERCY HEALTHCARE CENTERS
Active
Other names
Urosurgery Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS GRYZBEK (PRESIDENT)
(219) 932-2300
Entity
Organization
Contact information
Practice address
5454 HOHMAN AVE, 1 FLOOR C, HAMMOND, IN 46320-1931
(219) 932-5576
(219) 933-2655
Mailing address
PO BOX 1000, DYER, IN 46311-0800
(219) 864-2107
(219) 864-2251
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200159110O
—
IN
01
—
90000854
BCBS
IL
Enumeration date
09/17/2007
Last updated
02/04/2011
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