Provider Demographics
NPI:1831176874
Name:JANO, GHASSAN M (MD)
Entity type:Individual
Prefix:DR
First Name:GHASSAN
Middle Name:M
Last Name:JANO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 E 89TH AVE
Mailing Address - Street 2:SUITE 2A
Mailing Address - City:MERRILLVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46410-7319
Mailing Address - Country:US
Mailing Address - Phone:219-736-2800
Mailing Address - Fax:219-736-6680
Practice Address - Street 1:929 RIDGE RD
Practice Address - Street 2:SUITE 5
Practice Address - City:MUNSTER
Practice Address - State:IN
Practice Address - Zip Code:46321-1751
Practice Address - Country:US
Practice Address - Phone:219-836-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-30
Last Update Date:2013-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01040756207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000259103OtherANTHEM
000000259103OtherUNICARE
238806OtherWELLCARE
IN100465900Medicaid
IL91115213OtherBLUE CROSS/BLUE SHIELD
P00020073OtherTRAVELERS MEDICARE
000000259103OtherINDIANA CARPENTERS
9250110OtherADVOCATE PHO
000000259103OtherINDIANA CARPENTERS