Healthcare Provider Details

I. General information

NPI: 1508863846
Provider Name (Legal Business Name): NORTHERN INDIANA HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

640 INDUSTRIAL PKWY
ELKHART IN
46516-5414
US

IV. Provider business mailing address

640 INDUSTRIAL PKWY
ELKHART IN
46516-5414
US

V. Phone/Fax

Practice location:
  • Phone: 574-522-7203
  • Fax:
Mailing address:
  • Phone: 574-522-7203
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number StateIN
# 3
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateIN
# 4
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateIN

VIII. Authorized Official

Name: BENOIT O CHOINIERE
Title or Position: PRESIDENT
Credential:
Phone: 574-522-7203