MEDICARE: DR. LORI L. CHECKLEY M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	4301082974	MI
2	207QA0401X	Addiction Medicine (Family Medicine) Physician	01069750A	IN
3	207Q00000X	Family Medicine Physician	01069750A	IN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	169380005	OTHER	IN	MEDICARE
2	236040010	OTHER	IN	MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1437152394
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LORI L. CHECKLEY M.D.

Provider Business Mailing Address
First Line	:	17231 WILSHIRE DR
Second Line	:
City	:	SOUTH BEND
State	:	IN
Zip	:	46635-2068
Country	:	US
Telephone Number	:	269-445-7295
Fax Number	:

Provider Business Practice Location Address
First Line	:	17231 WILSHIRE DR
Second Line	:
City	:	SOUTH BEND
State	:	IN
Zip	:	46635-2068
Country	:	US
Telephone Number	:	269-445-7295
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/24/2005
Last Update Date	:	08/27/2022

Similar Medicare Providers

1730035577 — TAMIA SYMONE ROBINSON
Practice Location Address:

17551 GENERATIONS DR
SOUTH BEND, IN
46635-1589

Practice Phone: 574-400-2169
Practice Fax:

1427051341 — DR. JOHN GLENN MATHIS M.D.
Practice Location Address:

17501 GENERATIONS DR
SOUTH BEND, IN
46635-1589

Practice Phone: 574-234-0049
Practice Fax: 574-251-2861

1427051796 — SOUTH BEND IN ENDOSCOPY ASC LLC
Practice Location Address:

53830 GENERATIONS DR
SOUTH BEND, IN
46635-1557

Practice Phone: 574-271-0893
Practice Fax: 574-271-4362

1649272725 — DR. MICHAEL ALAN MANBECK M.D.
Practice Location Address:

17501 GENERATIONS DR
SOUTH BEND, IN
46635-1589

Practice Phone: 574-234-0049
Practice Fax: 574-251-2861

1497759765 — DR. OLIVER D GILLIAM M.D.
Practice Location Address:

17501 GENERATIONS DR
SOUTH BEND, IN
46635-1589

Practice Phone: 574-234-0049
Practice Fax: 574-251-2861

1063416931 — DONALD W SMITH MD
Practice Location Address:

6301 UNIVERSITY COMMONS
SOUTH BEND, IN
46635-1571

Practice Phone: 574-234-4016
Practice Fax: 574-239-4607

Directions to “ DR. LORI L. CHECKLEY M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.