Healthcare Provider Details

I. General information

NPI: 1992870893
Provider Name (Legal Business Name): THE WOMAN'S WELLNESS CENTER, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/24/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2590 MORTHLAND DR. SUITE 1
VALPARAISO IN
46385-6702
US

IV. Provider business mailing address

9136 COLUMBIA AVENUE
MUNSTER IN
46321-2907
US

V. Phone/Fax

Practice location:
  • Phone: 219-531-0200
  • Fax: 219-531-0045
Mailing address:
  • Phone: 219-836-0000
  • Fax: 219-836-5428

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number50002680A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number50002680A
License Number StateIN
# 3
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number50002680A
License Number StateIN

VIII. Authorized Official

Name: DR. JEFFREY YESSENOW
Title or Position: PRESIDENT
Credential: M.D.
Phone: 219-922-4200