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
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