MEDICARE: COMMUNITY HOSPITALS OF INDIANA INC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	IN
2	208000000X	Pediatrics Physician	IN
3	207Q00000X	Family Medicine Physician	IN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	CA1777	OTHER	IN	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	5085061	OTHER	IN	AETNA
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1689602047
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMMUNITY HOSPITALS OF INDIANA INC

Provider Business Mailing Address
First Line	:	3826 SOLUTIONS CTR
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60677-3008
Country	:	US
Telephone Number	:	317-355-5837
Fax Number	:	317-355-2205

Provider Business Practice Location Address
First Line	:	10122 E 10TH ST
Second Line	:	SUITE 100
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46229-2697
Country	:	US
Telephone Number	:	317-355-5717
Fax Number	:	317-355-3760

Authorized Official
Title or Position	:	CFO
Name	:	JEFFERY KIRKHAM
Credential	:
Telephone Number	:	317-355-4887

Provider Enumeration Date	:	06/28/2006
Last Update Date	:	10/14/2011

Similar Medicare Providers

1821790452 — VALARIE KUMALO MD
Practice Location Address:

10122 E 10TH ST STE 100
INDIANAPOLIS, IN
46229-2697

Practice Phone: 317-355-5717
Practice Fax: 317-355-3760

1912971029 — ARIA ARRIZABALAGA MD
Practice Location Address:

10122 E. 10TH STREET , SUITE 100
INDIANAPOLIS, IN
46229-2697

Practice Phone: 317-355-5717
Practice Fax: 317-355-3760

1528033107 — DR. LOUIS LEIGH WINTERNHEIMER M.D.
Practice Location Address:

10122 E 10TH ST STE 100
INDIANAPOLIS, IN
46229-2697

Practice Phone: 317-355-5717
Practice Fax:

1720044217 — SAGI VARGHESE MATHEW M.D.
Practice Location Address:

10122 E 10TH STREET , SUITE 100
INDIANAPOLIS, IN
46229-2697

Practice Phone: 317-355-6042
Practice Fax: 317-355-3760

1942233358 — KARL LEO OST M.D.
Practice Location Address:

10122 E. 10TH STREET , SUITE 100
INDIANAPOLIS, IN
46229-2697

Practice Phone: 317-355-5717
Practice Fax: 317-355-3760

1316971963 — STEPHANIE SUZANNE NADER LCSW
Practice Location Address:

10122 E. 10TH STREET , SUITE 100
INDIANAPOLIS, IN
46229-2697

Practice Phone: 317-355-5717
Practice Fax: 317-355-3760

Directions to “COMMUNITY HOSPITALS OF INDIANA INC ” Practice Location

Language	Start Address	Practice Location

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