Basic Information
| Provider Information | |||||||||
| NPI: | 1255917647 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | INFORME HC SPECIALISTS, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2741 W LAYTON AVE STE 106 | ||||||||
| Address2: | |||||||||
| City: | MILWAUKEE | ||||||||
| State: | WI | ||||||||
| PostalCode: | 532212600 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4142425468 | ||||||||
| FaxNumber: | 8887240875 | ||||||||
| Practice Location | |||||||||
| Address1: | 2300 GREAT LAKES DR | ||||||||
| Address2: | |||||||||
| City: | DYER | ||||||||
| State: | IN | ||||||||
| PostalCode: | 463111917 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2193223555 | ||||||||
| FaxNumber: | 8887240875 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/24/2021 | ||||||||
| LastUpdateDate: | 03/24/2021 | ||||||||
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| AuthorizedOfficialLastName: | CZERNEJEWSKI | ||||||||
| AuthorizedOfficialFirstName: | JODI | ||||||||
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| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 4142425468 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 03/24/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine | 207QH0002X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine | Hospice and Palliative Medicine | 207RH0002X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Hospice and Palliative Medicine | 207RI0200X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Infectious Disease | 207RS0012X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Sleep Medicine | 207R00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.