=====================================================
General NPI Number Information
=====================================================
NPI Number | 1225218068
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DIABETES AND ENDOCRINOLOGY CENTERS, LTD.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/09/2007
-----------------------------------------------------
Last Update Date | 07/21/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8230 CALUMET AVE
-----------------------------------------------------
City | MUNSTER
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 46321-1753
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 219-836-9600
-----------------------------------------------------
Fax | 219-836-9601
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2158 45TH ST # 233
-----------------------------------------------------
City | HIGHLAND
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 46322-3742
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 219-836-9600
-----------------------------------------------------
Fax | 219-836-9601
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | NABEEL JABRI
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 219-836-9600
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RE0101X
-----------------------------------------------------
Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------