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General NPI Number Information
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NPI Number | 1366238669
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Entity Type | Organization
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Legal Business Name | INDIANA PHYSICIAN SPECIALISTS LLC
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Dates
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Enumeration Date | 04/15/2025
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Last Update Date | 04/15/2025
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Provider Practice Location Address
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Address Line | 3847 EUCLID AVE
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City | EAST CHICAGO
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State | IN
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Zip | 46312-2332
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Country | US
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Telephone | 219-285-8224
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Fax | 219-285-8228
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Provider Business Mailing Address
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Address Line | 811 S CENTRAL EXPY STE 103
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City | RICHARDSON
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State | TX
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Zip | 75080-7439
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Country | US
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Telephone | 972-636-5727
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SYED KAZMI
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Credential | MD
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Telephone | 219-285-8224
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP3300X
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Taxonomy Name | Pain Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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