Individual
DR. JUDE KIELTYKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
600 GRANT ST, GARY, IN 46402-6001
(847) 571-2551
Mailing address
600 GRANT ST, GARY, IN 46402-6001
(847) 571-2551
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
01075095A
IN
207P00000X
Emergency Medicine Physician
036135364
IL
Other
Enumeration date
06/28/2011
Last updated
05/04/2017
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