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General NPI Number Information
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NPI Number | 1457358418
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Entity Type | Organization
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Legal Business Name | NORTHERN INDIANA HEALTH CENTER
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Dates
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Enumeration Date | 07/06/2005
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 2610 E JEFFERSON BLVD
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City | SOUTH BEND
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State | IN
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Zip | 46615-2724
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Country | US
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Telephone | 574-232-3000
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Fax |
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Provider Business Mailing Address
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Address Line | 2610 E JEFFERSON BLVD
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City | SOUTH BEND
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State | IN
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Zip | 46615-2724
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Country | US
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Telephone | 574-232-3000
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | BENOIT O CHOINIERE
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Credential |
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Telephone | 574-522-7203
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State | IN
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Taxonomy #4
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State | IN
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