Provider Demographics
NPI:1942374194
Name:CHHABRA MEDICAL CORPORATION PC
Entity Type:Organization
Organization Name:CHHABRA MEDICAL CORPORATION PC
Other - Org Name:HOBART HEALTH CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:MD/ OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BHUPINDAR
Authorized Official - Middle Name:
Authorized Official - Last Name:CHHABRA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:219-762-3196
Mailing Address - Street 1:6375 U S HWY 6 SUITE A
Mailing Address - Street 2:
Mailing Address - City:PORTAGE
Mailing Address - State:IN
Mailing Address - Zip Code:46368-5218
Mailing Address - Country:US
Mailing Address - Phone:219-762-3196
Mailing Address - Fax:219-763-6438
Practice Address - Street 1:7835 GRAND BLVD.
Practice Address - Street 2:
Practice Address - City:HOBART
Practice Address - State:IN
Practice Address - Zip Code:46342-6387
Practice Address - Country:US
Practice Address - Phone:219-769-2258
Practice Address - Fax:219-769-2743
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-20
Last Update Date:2022-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207Q00000X
IN01034231A261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200140300BMedicaid