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Contact Information

INDIANA UNIVERSITY SOUTH BEND HEALTH & WELLNESS CENTER
941 20TH STREET
SOUTH BEND, IN46634-7111
 Phone: 574-520-5557
 Fax: 574-520-5042
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Internal Medicine

207R00000X 11 Physician/Internal Medicine
 

Health Maintenance Organization

302R00000X
 

Licensed Practical Nurse

164W00000X
Indicates primary specialty

NPI Profile & details for INDIANA UNIVERSITY SOUTH BEND HEALTH WELLNESS CENTER · (Female)

NPI Number 1952721185
Status Active
Credentials
Entity Individual
Enumeration date 04/28/2014
Last updated 04/28/2014 - About 12 years ago
Sole proprietor 1 Not specified
Identifiers
  • IN License # 01046709
  • IN License # 28076706A
  • IN License # 28156667A
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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