Organization
ILLIANA SURGERY AND MEDICAL CENTER, LLC
Active
Other names
The Orthopedic Centers, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
VIJAY GUPTA M.D. (CEO)
(219) 922-4200
Entity
Organization
Contact information
Practice address
6375 US HIGHWAY 6, STE 3, PORTAGE, IN 46368-5111
(219) 641-3051
Mailing address
701 SUPERIOR AVE, ATTN: MANAGED CARE, MUNSTER, IN 46321-4037
(219) 641-3051
(219) 641-4186
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
IN
Other
Enumeration date
07/26/2005
Last updated
08/22/2020
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