MEDICARE: NWI PRIMARY CARE LLC

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

General Provider Information

NPI Number	:	1689077620
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NWI PRIMARY CARE LLC

Provider Business Mailing Address
First Line	:	642 S LAKE ST
Second Line	:
City	:	GARY
State	:	IN
Zip	:	46403-2967
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	642 S LAKE ST
Second Line	:
City	:	GARY
State	:	IN
Zip	:	46403-2967
Country	:	US
Telephone Number	:	219-794-4024
Fax Number	:

Authorized Official
Title or Position	:	CEO/PRESIDENT
Name	:	MS. PAULA JEAN ROUSIS
Credential	:	RN
Telephone Number	:	219-794-4024

Provider Enumeration Date	:	10/05/2014
Last Update Date	:	10/05/2014

Similar Medicare Providers

1801894076 — DR. TEOFILO S BAUTISTA M.D., P.C.
Practice Location Address:

642 S LAKE ST
GARY, IN
46403-2967

Practice Phone: 219-938-4481
Practice Fax: 219-938-6480

1215110200 — TEOFILO S. BAUTISTA, M.D., P.C
Practice Location Address:

642 S LAKE ST
GARY, IN
46403-2967

Practice Phone: 219-938-4481
Practice Fax: 219-938-6480

1487593539 — PREMIER CARE COORDINATION
Practice Location Address:

219 N LAKE ST
GARY, IN
46403-1964

Practice Phone: 317-751-1772
Practice Fax:

1386591485 — MRS. MAKEBA Q FARLEY ACIT II, MATS
Practice Location Address:

5001 EAST DUNES HIGHWAY
GARY, IN
46403

Practice Phone: 219-938-4651
Practice Fax: 219-938-9210

1225984388 — NESTING HOME CARE SOLUTIONS LLC
Practice Location Address:

4134 E 5TH PL
GARY, IN
46403-2701

Practice Phone: 630-430-1006
Practice Fax:

1538016589 — DARRYLL ANTHONY COLEMAN
Practice Location Address:

830 FLOYD ST
GARY, IN
46403-2945

Practice Phone: 219-308-7602
Practice Fax:

Directions to “NWI PRIMARY CARE LLC ” 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.