Individual
LILLIAN SANDIC JARDINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5735 S IRONWOOD RD, SOUTH BEND, IN 46614-9668
(574) 299-4847
(574) 299-9073
Mailing address
5735 S IRONWOOD RD, SOUTH BEND, IN 46614-9668
(574) 299-4847
(574) 299-9073
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
01061418A
IN
207Q00000X
Family Medicine Physician
Primary
4301072875
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1720188956
—
MI
Enumeration date
09/25/2006
Last updated
06/09/2015
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