Provider Demographics
NPI:1003405762
Name:INDIANA ALLERGY AND ASTHMA LLC
Entity Type:Organization
Organization Name:INDIANA ALLERGY AND ASTHMA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:POOJA
Authorized Official - Middle Name:OZA
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-361-3602
Mailing Address - Street 1:9012 CONNECTICUT ST
Mailing Address - Street 2:
Mailing Address - City:MERRILLVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46410-7057
Mailing Address - Country:US
Mailing Address - Phone:219-769-6177
Mailing Address - Fax:
Practice Address - Street 1:9012 CONNECTICUT ST
Practice Address - Street 2:
Practice Address - City:MERRILLVILLE
Practice Address - State:IN
Practice Address - Zip Code:46410-7057
Practice Address - Country:US
Practice Address - Phone:219-769-6177
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-15
Last Update Date:2021-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty