| Childrens & Family Medicine Clinic Pc | |
|
9128 Columbia Ave Ste A Munster IN 46321-2547 | |
| (219) 836-2730 | |
| (219) 836-0244 |
| Full Name | Childrens & Family Medicine Clinic Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 9128 Columbia Ave Ste A, Munster, Indiana |
| Authorized Official Name and Position | Zeba Ali (PRESIDENT) |
| Authorized Official Contact | 7342723448 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Childrens & Family Medicine Clinic Pc 9128 Columbia Ave Ste A Munster IN 46321-2547 Ph: (219) 836-2730 | Childrens & Family Medicine Clinic Pc 9128 Columbia Ave Ste A Munster IN 46321-2547 Ph: (219) 836-2730 |
| NPI Number | 1265978043 |
|---|---|
| Provider Enumeration Date | 01/17/2017 |
| Last Update Date | 01/17/2017 |
| Medicare PECOS PAC ID | 3870876550 |
|---|---|
| Medicare Enrollment ID | O20170202001547 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265978043 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Tammie M Erdelac |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629247713 PECOS PAC ID: 1254382245 Enrollment ID: I20050208000139 |
| Provider Name | Zeba Ali |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962472159 PECOS PAC ID: 0244260966 Enrollment ID: I20050812000626 |
| Provider Name | Azra Shibli Sheriff |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1053321141 PECOS PAC ID: 6305848292 Enrollment ID: I20070206000301 |
| Provider Name | Christina R Pisterzi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255768966 PECOS PAC ID: 9335377860 Enrollment ID: I20200420000947 |
| Provider Name | Olaide Avoseh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053189621 PECOS PAC ID: 8224480561 Enrollment ID: I20240123000378 |
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