Organization
ABC PEDIATRIACS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TODD JOHNSON (AR MGR.)
(219) 662-3931
Entity
Organization
Contact information
Practice address
6750 CALUMET AVE, HAMMOND, IN 46324-1646
(219) 803-0311
(219) 803-0217
Mailing address
PO BOX 1154, CROWN POINT, IN 46308-1154
(219) 662-3931
(219) 663-6359
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
01053391A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200978100A
—
IN
05
—
305761883
—
IL
Enumeration date
04/16/2010
Last updated
02/15/2011
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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