=====================================================
General NPI Number Information
=====================================================
NPI Number | 1942305347
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | WHITING MEDICAL CENTER S C
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/13/2006
-----------------------------------------------------
Last Update Date | 07/25/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2075 INDIANAPOLIS BLVD
-----------------------------------------------------
City | WHITING
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 46394-1948
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 219-659-7000
-----------------------------------------------------
Fax | 219-659-9018
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2075 INDIANAPOLIS BLVD
-----------------------------------------------------
City | WHITING
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 46394-1948
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 219-659-7000
-----------------------------------------------------
Fax | 219-659-9018
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT/OWNER
-----------------------------------------------------
Name | MR. CHITTARANJAN AMBALAL PATEL
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 219-659-7000
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QM1300X
-----------------------------------------------------
Taxonomy Name | Multi-Specialty Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------