| Midwest Neurology Associates Pc | |
|
1100 Joliet St Ste 201 Dyer IN 46311-1995 | |
| (219) 836-2096 | |
| (219) 836-2097 |
| Full Name | Midwest Neurology Associates Pc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1100 Joliet St Ste 201, Dyer, Indiana |
| Authorized Official Name and Position | Samer Kassar (OWNER) |
| Authorized Official Contact | 2198362096 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Midwest Neurology Associates Pc Po Box 423 Dyer IN 46311-0423 Ph: (219) 836-2096 | Midwest Neurology Associates Pc 1100 Joliet St Ste 201 Dyer IN 46311-1995 Ph: (219) 836-2096 |
| NPI Number | 1124453279 |
|---|---|
| Provider Enumeration Date | 09/09/2013 |
| Last Update Date | 01/31/2018 |
| Medicare PECOS PAC ID | 3779710660 |
|---|---|
| Medicare Enrollment ID | O20131223000284 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124453279 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | 01073001A (Indiana) | Primary |
| Provider Name | Samer Kassar |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1902839525 PECOS PAC ID: 3375547128 Enrollment ID: I20131223000515 |
| Provider Name | Michelle Anne Terwilliger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912360546 PECOS PAC ID: 8123327970 Enrollment ID: I20160428000901 |
| Provider Name | Maher Fattouh |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1457309965 PECOS PAC ID: 4385639970 Enrollment ID: I20200428000150 |
| Provider Name | Mostafa Farache |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1366646879 PECOS PAC ID: 7618041740 Enrollment ID: I20220615000892 |
| Provider Name | Vanessa Almanza |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720847478 PECOS PAC ID: 2860934007 Enrollment ID: I20240604000788 |
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