Healthcare Provider Details

I. General information

NPI: 1275032062
Provider Name (Legal Business Name): NORTHWEST INDIANA ORTHOPEDICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/07/2018
Last Update Date: 02/07/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11360 BROADWAY
CROWN POINT IN
46307-7197
US

IV. Provider business mailing address

5355 COMMERCE BLVD
CROWN POINT IN
46307-5325
US

V. Phone/Fax

Practice location:
  • Phone: 219-756-0600
  • Fax: 219-756-0608
Mailing address:
  • Phone: 219-756-0600
  • Fax: 219-756-0608

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207XP3100X
TaxonomyPediatric Orthopaedic Surgery Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ARTHUR H KATZ
Title or Position: CO-PRESIDENT
Credential: M.D.
Phone: 219-756-0600