Healthcare Provider Details

I. General information

NPI: 1376714345
Provider Name (Legal Business Name): LAKESHORE BONE & JOINT INSTITUTE, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/18/2008
Last Update Date: 06/25/2025
Certification Date: 06/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 GATEWAY N BLVD
CHESTERTON IN
46304-9658
US

IV. Provider business mailing address

601 GATEWAY N BLVD
CHESTERTON IN
46304-9658
US

V. Phone/Fax

Practice location:
  • Phone: 219-921-1444
  • Fax: 219-921-5303
Mailing address:
  • Phone: 219-921-1444
  • Fax: 219-921-5303

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number State

VIII. Authorized Official

Name: AARON G ANDERSON
Title or Position: PRESIDENT
Credential: M.D.
Phone: 219-921-1444