Organization
INTERNAL MEDICINE CENTER OF NW INDIANA, PC
Active
Other names
Advanced Rehabilitation Services
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ROBYN DALE POLK CRTT (ADMINISTRATOR)
(219) 985-1112
Entity
Organization
Contact information
Practice address
5800 BROADWAY, MERRILLVILLE, IN 46410-2601
(219) 985-1112
(219) 985-1150
Mailing address
5800 BROADWAY, MERRILLVILLE, IN 46410-2601
(219) 985-1112
(219) 985-1150
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05007981A
IN
227800000X
Certified Respiratory Therapist
30001325A
IN
227800000X
Certified Respiratory Therapist
30001586A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200121630A
—
IN
Enumeration date
02/01/2007
Last updated
04/12/2011
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