Healthcare Provider Details
I. General information
NPI: 1972420081
Provider Name (Legal Business Name): MUNSTER AMBULATORY SURGERY CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/30/2026
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9410 CALUMET AVE STE 304
MUNSTER IN
46321-0018
US
IV. Provider business mailing address
PO BOX 737581
CHICAGO IL
60673-7581
US
V. Phone/Fax
- Phone: 219-389-2243
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QA1903X |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
EDWARD
J
KOWLOWITZ
Title or Position: OWNER
Credential: MD
Phone: 317-409-7246