Provider Demographics
NPI:1598923880
Name:COMMUNITY CARE NETWORK
Entity Type:Organization
Organization Name:COMMUNITY CARE NETWORK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF MANAGED CARE
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:HILBURGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:219-392-7064
Mailing Address - Street 1:4321 FIR ST
Mailing Address - Street 2:
Mailing Address - City:EAST CHICAGO
Mailing Address - State:IN
Mailing Address - Zip Code:46312-3049
Mailing Address - Country:US
Mailing Address - Phone:219-392-7064
Mailing Address - Fax:219-392-7089
Practice Address - Street 1:4035 ELM ST
Practice Address - Street 2:
Practice Address - City:EAST CHICAGO
Practice Address - State:IN
Practice Address - Zip Code:46312-3042
Practice Address - Country:US
Practice Address - Phone:219-398-9840
Practice Address - Fax:219-398-9845
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ST. CATHERINE HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-05-23
Last Update Date:2010-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
INC31254Medicare PIN