| Calumet Quick Care Ltd | |
|
5518 Calumet Ave Hammond IN 46320-2017 | |
| (888) 855-2995 | |
| Not Available |
| Full Name | Calumet Quick Care Ltd |
|---|---|
| Speciality | Family Medicine |
| Location | 5518 Calumet Ave, Hammond, Indiana |
| Authorized Official Name and Position | Richard O Watson (OWNER) |
| Authorized Official Contact | 8888552995 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Calumet Quick Care Ltd Po Box 786 Flossmoor IL 60422-0786 Ph: (888) 855-2995 | Calumet Quick Care Ltd 5518 Calumet Ave Hammond IN 46320-2017 Ph: (888) 855-2995 |
| NPI Number | 1861150419 |
|---|---|
| Provider Enumeration Date | 12/01/2021 |
| Last Update Date | 09/07/2022 |
| Medicare PECOS PAC ID | 9436526258 |
|---|---|
| Medicare Enrollment ID | O20221108002965 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861150419 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Richard O Watson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1962472886 PECOS PAC ID: 7113095688 Enrollment ID: I20091013000081 |
| Provider Name | Briana N Young |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1750532065 PECOS PAC ID: 6800924101 Enrollment ID: I20100506000791 |
| Provider Name | Jarrod Barker |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1801013164 PECOS PAC ID: 6800074956 Enrollment ID: I20110621000237 |
| Provider Name | Nichelle M Bush |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447647110 PECOS PAC ID: 2365762291 Enrollment ID: I20150518000580 |
| Provider Name | Derwin Phillip |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1871688341 PECOS PAC ID: 1557491073 Enrollment ID: I20230429000347 |
| Provider Name | Tracie Clisby |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942574769 PECOS PAC ID: 3173779303 Enrollment ID: I20230515001567 |
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