Provider Demographics
NPI:1609322890
Name:NEUROLOGY CONSULTANTS OF NORTHWEST INDIANA, P.C.
Entity Type:Organization
Organization Name:NEUROLOGY CONSULTANTS OF NORTHWEST INDIANA, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:AISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAREEF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:219-750-9665
Mailing Address - Street 1:5521 W LINCOLN HWY
Mailing Address - Street 2:SUITE 300
Mailing Address - City:CROWN POINT
Mailing Address - State:IN
Mailing Address - Zip Code:46307-1097
Mailing Address - Country:US
Mailing Address - Phone:219-750-9665
Mailing Address - Fax:219-750-9672
Practice Address - Street 1:5521 W LINCOLN HWY
Practice Address - Street 2:SUITE 300
Practice Address - City:CROWN POINT
Practice Address - State:IN
Practice Address - Zip Code:46307-1097
Practice Address - Country:US
Practice Address - Phone:219-750-9665
Practice Address - Fax:219-750-9672
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-29
Last Update Date:2016-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01067804A2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty