| Dr Irene Dmitruk, DO | |
|
9660 Wicker Ave, Saint John, IN 46373-9487 | |
| (219) 365-1177 | |
| (219) 703-6662 |
| Full Name | Dr Irene Dmitruk |
|---|---|
| Gender | Female |
| Speciality | Emergency Medicine |
| Experience | 17 Years |
| Location | 9660 Wicker Ave, Saint John, Indiana |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861703399 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207P00000X | Emergency Medicine | 11014502A (Indiana) | Secondary |
| 207P00000X | Emergency Medicine | 02003817A (Illinois) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| St Mary Medical Center Inc | Hobart, IN | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Cep America Llc | 6608056171 | 732 |
| Entity Name | Community Care Network Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1457610487 PECOS PAC ID: 3678737012 Enrollment ID: O20120614000331 |
| Entity Name | Cep America Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1285103671 PECOS PAC ID: 6608056171 Enrollment ID: O20190214000611 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Irene Dmitruk, DO 8558 Broadway, Merrillville, IN 46410-7032 Ph: (201) 961-2477 | Dr Irene Dmitruk, DO 9660 Wicker Ave, Saint John, IN 46373-9487 Ph: (219) 365-1177 |
Saaduddin Mohammed Siddiqui, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 9660 Wicker Ave, Saint John, IN 46373 Phone: 219-365-1177 Fax: 219-703-6662 | |
Nadim Hafez, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 9660 Wicker Ave, Saint John, IN 46373 Phone: 219-365-1177 Fax: 219-703-6662 | |
Brooke Mcdermott, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 9660 Wicker Ave, Saint John, IN 46373 Phone: 219-365-1166 Fax: 219-365-8852 |