Provider Demographics
NPI:1225218068
Name:DIABETES AND ENDOCRINOLOGY CENTERS, LTD.
Entity Type:Organization
Organization Name:DIABETES AND ENDOCRINOLOGY CENTERS, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NABEEL
Authorized Official - Middle Name:
Authorized Official - Last Name:JABRI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:219-836-9600
Mailing Address - Street 1:2158 45TH ST
Mailing Address - Street 2:# 233
Mailing Address - City:HIGHLAND
Mailing Address - State:IN
Mailing Address - Zip Code:46322-3742
Mailing Address - Country:US
Mailing Address - Phone:219-836-9600
Mailing Address - Fax:219-836-9601
Practice Address - Street 1:8230 CALUMET AVE
Practice Address - Street 2:
Practice Address - City:MUNSTER
Practice Address - State:IN
Practice Address - Zip Code:46321-1753
Practice Address - Country:US
Practice Address - Phone:219-836-9600
Practice Address - Fax:219-836-9601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-09
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL324724679Medicaid
P00457612OtherMEDICARE RAILROAD
IN200888130AMedicaid
90001353OtherBCBS IL
IN000000548427OtherBCBS IN
IL324724679Medicaid
IN254840Medicare PIN