Provider Demographics
NPI:1710594486
Name:DEMKO GROUP LLC
Entity Type:Organization
Organization Name:DEMKO GROUP LLC
Other - Org Name:THE DEMKO CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:
Authorized Official - Last Name:DEMKO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:219-508-4154
Mailing Address - Street 1:6908 W 200 N
Mailing Address - Street 2:
Mailing Address - City:LA PORTE
Mailing Address - State:IN
Mailing Address - Zip Code:46350-9734
Mailing Address - Country:US
Mailing Address - Phone:219-508-4154
Mailing Address - Fax:
Practice Address - Street 1:810 MICHAEL DR STE E
Practice Address - Street 2:
Practice Address - City:CHESTERTON
Practice Address - State:IN
Practice Address - Zip Code:46304-2695
Practice Address - Country:US
Practice Address - Phone:219-921-2095
Practice Address - Fax:219-533-4014
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-28
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty