Provider Demographics
NPI:1942321294
Name:NORTHWEST PROCEDURES MEDICAL CENTER AND IMMEDIATE CARE CENTERS
Entity Type:Organization
Organization Name:NORTHWEST PROCEDURES MEDICAL CENTER AND IMMEDIATE CARE CENTERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GEOFFREY
Authorized Official - Middle Name:OKECHUKWU
Authorized Official - Last Name:ONYEUKWU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:219-884-3447
Mailing Address - Street 1:3814 GRANT ST
Mailing Address - Street 2:
Mailing Address - City:GARY
Mailing Address - State:IN
Mailing Address - Zip Code:46408-2150
Mailing Address - Country:US
Mailing Address - Phone:219-397-1951
Mailing Address - Fax:219-397-2668
Practice Address - Street 1:2010 E COLUMBUS DR
Practice Address - Street 2:
Practice Address - City:EAST CHICAGO
Practice Address - State:IN
Practice Address - Zip Code:46312-2830
Practice Address - Country:US
Practice Address - Phone:219-397-1951
Practice Address - Fax:219-397-2668
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-03
Last Update Date:2008-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01043017A261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center