| Paragon Clinical Midwest, Llc | |
|
8380 Virginia St Merrillville IN 46410 | |
| (630) 832-1775 | |
| Not Available |
| Full Name | Paragon Clinical Midwest, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 8380 Virginia St, Merrillville, Indiana |
| Authorized Official Name and Position | Marybeth Sutkowski (CHIEF MEDICAL OFFICER/PRINCIPAL) |
| Authorized Official Contact | 6308321775 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Paragon Clinical Midwest, Llc Po Box 2477 Shelton CT 06484-1477 Ph: (630) 506-1245 | Paragon Clinical Midwest, Llc 8380 Virginia St Merrillville IN 46410 Ph: (630) 832-1775 |
| NPI Number | 1619335700 |
|---|---|
| Provider Enumeration Date | 02/03/2016 |
| Last Update Date | 01/18/2024 |
| Medicare PECOS PAC ID | 2860791647 |
|---|---|
| Medicare Enrollment ID | O20160428001881 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619335700 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Marybeth E Sutkowski |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1447369293 PECOS PAC ID: 3476742024 Enrollment ID: I20151201000178 |
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