Healthcare Provider Details

I. General information

NPI: 1083582092
Provider Name (Legal Business Name): KRISTI L DRESBAUGH CSFA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/29/2025
Last Update Date: 10/30/2025
Certification Date: 10/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8701 BROADWAY
MERRILLVILLE IN
46410-7035
US

IV. Provider business mailing address

3051 SPRINGMILL ST
PORTAGE IN
46368-4415
US

V. Phone/Fax

Practice location:
  • Phone: 219-738-5500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number84011
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: