Healthcare Provider Details

I. General information

NPI: 1205756756
Provider Name (Legal Business Name): JULIA PYSH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2026
Last Update Date: 07/16/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 169TH ST, HAMMOND, IN 46323
HAMMOND IN
46323
US

IV. Provider business mailing address

9543 MCKINLEY ST
CROWN POINT IN
46307-2021
US

V. Phone/Fax

Practice location:
  • Phone: 219-989-2400
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: