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Organization

ST MARGARET MERCY HEALTHCARE CENTERS

Active
Other names
Orthopedic Clinic
Organization subpart
No

Provider details

NPI number
Authorized official
THOMAS GRYZBEK (PRESIDENT)
(219) 932-2300
Entity
Organization

Contact information

Practice address
5454 HOHMAN AVE, HAMMOND, IN 46320-1931
(219) 933-7930
(219) 933-2655
Mailing address
PO BOX 1000, DYER, IN 46311-0800
(219) 864-2107
(219) 864-2251

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
207XS0117X
Orthopaedic Surgery of the Spine Physician

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200159110K
IN
01
90000854
BCBC
IL
Enumeration date
11/29/2006
Last updated
02/04/2011
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