| Nwi Home Doctor Llc | |
|
3847 Euclid Ave East Chicago IN 46312-2332 | |
| (219) 949-7540 | |
| Not Available |
| Full Name | Nwi Home Doctor Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 3847 Euclid Ave, East Chicago, Indiana |
| Authorized Official Name and Position | Paul Okolocha (PRESIDENT) |
| Authorized Official Contact | 2199497540 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Nwi Home Doctor Llc 3847 Euclid Ave East Chicago IN 46312-2332 Ph: () - | Nwi Home Doctor Llc 3847 Euclid Ave East Chicago IN 46312-2332 Ph: (219) 949-7540 |
| NPI Number | 1093212888 |
|---|---|
| Provider Enumeration Date | 04/09/2018 |
| Last Update Date | 04/09/2018 |
| Medicare PECOS PAC ID | 0446506570 |
|---|---|
| Medicare Enrollment ID | O20180703002196 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093212888 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QA0505X | Family Medicine - Adult Medicine | (* (Not Available)) | Primary |
| Provider Name | Michael S Adeleke |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1447221700 PECOS PAC ID: 5496704447 Enrollment ID: I20050117000207 |
| Provider Name | Paul C Okolocha |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629193321 PECOS PAC ID: 2860421104 Enrollment ID: I20100522000064 |
| Provider Name | Sandra Renee Gates Manna |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124396072 PECOS PAC ID: 0749431203 Enrollment ID: I20121108000643 |
| Provider Name | David D Chube |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124024096 PECOS PAC ID: 9335406172 Enrollment ID: I20171201002372 |
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