Organization
ST MARGARET MERCY HEALTHCARE CENTERS, INC.
Active
Organization
ST MARGARET MERCY HEALTHCARE CENTERS, INC.
Active
Other names
East Chicago Family Services
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS GRYZBEK (PRESIDENT)
(219) 932-2300
Entity
Organization
Contact information
Practice address
2001 E COLUMBUS DR, SUITE # C, EAST CHICAGO, IN 46312-2829
(219) 933-2623
(219) 378-9283
Mailing address
PO BOX 1000, DYER, IN 46311-0800
(219) 864-2107
(219) 864-2251
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0090000854
BCBS GROUP NUMBER
IL
05
—
200159110J
—
IN
Enumeration date
11/03/2006
Last updated
06/23/2008
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