Provider Demographics
NPI:1851563605
Name:HOOSIER HOUSECALLS, PC
Entity Type:Organization
Organization Name:HOOSIER HOUSECALLS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:C
Authorized Official - Last Name:TREEP
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:317-776-9214
Mailing Address - Street 1:PO BOX 6328
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46038-6328
Mailing Address - Country:US
Mailing Address - Phone:971-776-9214
Mailing Address - Fax:317-776-9219
Practice Address - Street 1:10017 WATER CREST DR
Practice Address - Street 2:
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46038-7127
Practice Address - Country:US
Practice Address - Phone:971-776-9214
Practice Address - Fax:317-776-9219
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-01
Last Update Date:2009-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL110236660OtherRAILROAD MEDICARE
IL110236660OtherRAILROAD MEDICARE