Individual
DR. IRENE DMITRUK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
9660 WICKER AVE, SAINT JOHN, IN 46373-9487
(219) 365-1177
(219) 703-6662
Mailing address
8558 BROADWAY, MERRILLVILLE, IN 46410-7032
(201) 961-2477
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
02003817A
IL
207P00000X
Emergency Medicine Physician
11014502A
IN
Other
Enumeration date
06/30/2010
Last updated
12/21/2020
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