Organization
NORTHSHORE HEALTH CENTERS, INC.
Active
Organization
NORTHSHORE HEALTH CENTERS, INC.
Active
Other names
NorthShore Chesterton Middle School Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID HALL (CEO)
(219) 763-8112
Entity
Organization
Contact information
Practice address
651 W MORGAN AVE RM F168, CHESTERTON, IN 46304-2243
(219) 763-8112
(219) 764-5380
Mailing address
PO BOX 1430, PORTAGE, IN 46368-9230
(219) 763-8112
(219) 764-5380
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
10/07/2020
Last updated
11/05/2020
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