Organization
NORTHWEST CENTER MEDICAL SERVICES CORP.
Active
Organization
NORTHWEST CENTER MEDICAL SERVICES CORP.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANICE ZUNICH M.D. (DIRECTOR, GENETICS CENTER)
(219) 980-6560
Entity
Organization
Contact information
Practice address
3400 BROADWAY, GARY, IN 46408-1101
(219) 980-6560
(219) 980-6693
Mailing address
3400 BROADWAY, GARY, IN 46408-1101
(219) 980-6560
(219) 980-6693
Taxonomy
Speciality
Code
Description
License number
State
207SG0201X
Clinical Genetics (M.D.) Physician
Primary
01034255A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000079455
BLUE CROSS BLUE SHIELD PIN#
—
05
—
100213240A
—
IN
01
—
2047365
AETNA PROVIDER NUMBER
—
01
—
370019259
MEDICARE RAILROAD PIN
IN
01
—
911-15448
BLUE CROSS BLUES SHIELD OF IL PROVIDER#
—
Enumeration date
02/04/2008
Last updated
06/09/2008
Update your record
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