Provider Demographics
NPI:1952566283
Name:DOCTORS ON CALL LLC
Entity Type:Organization
Organization Name:DOCTORS ON CALL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MOHAMED
Authorized Official - Middle Name:SAEED
Authorized Official - Last Name:IBRAHIM
Authorized Official - Suffix:
Authorized Official - Credentials:LICENSE PHYSICAL TH
Authorized Official - Phone:219-448-0667
Mailing Address - Street 1:2075 INDIANAPOLIS BLVD
Mailing Address - Street 2:
Mailing Address - City:WHITING
Mailing Address - State:IN
Mailing Address - Zip Code:46394-1948
Mailing Address - Country:US
Mailing Address - Phone:219-659-2255
Mailing Address - Fax:708-233-1232
Practice Address - Street 1:2075 INDIANAPOLIS BLVD
Practice Address - Street 2:
Practice Address - City:WHITING
Practice Address - State:IN
Practice Address - Zip Code:46394-1948
Practice Address - Country:US
Practice Address - Phone:219-659-2255
Practice Address - Fax:708-233-1232
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-25
Last Update Date:2008-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036096495208D00000X
IN05003890A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty