Provider Demographics
NPI:1922546530
Name:PINNACLE HEALTHCARE, LLC
Entity Type:Organization
Organization Name:PINNACLE HEALTHCARE, LLC
Other - Org Name:LAKE ORTHOPEDIC AND SPINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:HAROON
Authorized Official - Middle Name:RASHID
Authorized Official - Last Name:ANSARI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:219-796-4103
Mailing Address - Street 1:9301 CONNECTICUT DR
Mailing Address - Street 2:
Mailing Address - City:CROWN POINT
Mailing Address - State:IN
Mailing Address - Zip Code:46307-7486
Mailing Address - Country:US
Mailing Address - Phone:219-756-2100
Mailing Address - Fax:
Practice Address - Street 1:8550 BROADWAY
Practice Address - Street 2:
Practice Address - City:MERRILLVILLE
Practice Address - State:IN
Practice Address - Zip Code:46410-7173
Practice Address - Country:US
Practice Address - Phone:219-795-1890
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-02
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty