Provider Demographics
NPI:1215966171
Name:NORTHWEST INDIANA HAND & PT
Entity type:Organization
Organization Name:NORTHWEST INDIANA HAND & PT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:M
Authorized Official - Last Name:CAGEN
Authorized Official - Suffix:
Authorized Official - Credentials:OTR L, CHT
Authorized Official - Phone:219-465-7554
Mailing Address - Street 1:605 MCCORD RD
Mailing Address - Street 2:
Mailing Address - City:VALPARAISO
Mailing Address - State:IN
Mailing Address - Zip Code:46383-3646
Mailing Address - Country:US
Mailing Address - Phone:219-462-1554
Mailing Address - Fax:219-462-6028
Practice Address - Street 1:605 MCCORD RD
Practice Address - Street 2:
Practice Address - City:VALPARAISO
Practice Address - State:IN
Practice Address - Zip Code:46383-3646
Practice Address - Country:US
Practice Address - Phone:219-462-1554
Practice Address - Fax:219-462-6028
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31000637A225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHandGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000103290OtherANTHEM
IN658990Medicare ID - Type Unspecified
INCB3668Medicare ID - Type UnspecifiedRR