=====================================================
General NPI Number Information
=====================================================
NPI Number | 1629036363
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | STERLING EMERGENCY SERVICES OF INDIANA, INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/03/2006
-----------------------------------------------------
Last Update Date | 09/11/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8701 BROADWAY
-----------------------------------------------------
City | MERRILLVILLE
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 46410-7035
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 219-738-5500
-----------------------------------------------------
Fax | 904-805-1302
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3086 SOLUTIONS CTR
-----------------------------------------------------
City | CHICAGO
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60677-3000
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 904-805-1300
-----------------------------------------------------
Fax | 904-805-1302
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO/PRESIDENT
-----------------------------------------------------
Name | EUGENE DAUCHERT
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 919-768-4392
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207P00000X
-----------------------------------------------------
Taxonomy Name | Emergency Medicine Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363A00000X
-----------------------------------------------------
Taxonomy Name | Physician Assistant
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 363L00000X
-----------------------------------------------------
Taxonomy Name | Nurse Practitioner
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------