Active NPI
Dr Mary Tilak PC
- Obesity Medicine (Internal Medicine) Physician
- Munster, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obesity Medicine (Internal Medicine) Physician
- Legal business name
- DR MARY TILAK PC
- Practice address
- 9410 Calumet Ave Ste 101
Munster, IN 46321-2812 - Phone
- (219) 922-8051
- Fax
- (219) 922-8608
- NPI assigned
- Nov 7, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mary N. Tilak, M.D.
- Title
- President
- Phone
- (219) 922-8051
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obesity Medicine (Internal Medicine) Physician | 207RB0002X | Primary |
Addresses
Primary practice location
9410 Calumet Ave Ste 101
Munster, IN 46321-2812
Mailing address
PO Box 736895
Chicago, IL 60673-6895
Phone (219) 922-8051
Other practice location 1
6625 W Lincoln Hwy
Crown Point, IN 46307-9678
Phone (219) 922-8051
Other practice location 2
1275 E North St Ste 102
Crown Point, IN 46307-3541
Phone (219) 922-8051
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000541656 | Other | IN | ANTHEM |
| 90001352 | Other | IL | BC/BS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20071207000544 | IN | Part B Supplier - Clinic/Group Practice | 1951490390 |
Receives reassigned benefits from 20 practitioners Practice locations: Crown Point, IN; Munster, IN |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 15D1035173 | Dr Mary Tilak PC | Certificate of waiver | Dec 21, 2026 |
| 15D2021147 | Dr Mary Tilak PC | Certificate of waiver | Mar 6, 2027 |
National Provider Directory
National Provider DirectoryLocations
6625 W Lincoln Hwy
Ste A
Crown Point, IN 46307
2203 45th St
Highland, IN 46322
209 E 86TH Ave
Merrillville, IN 46410
Phone (219) 922-8051
9410 Calumet Ave
Ste 8051
Munster, IN 46321
9450 Calumet Ave
Ste 101
Munster, IN 46321
9410 Calumet Ave
Ste 100
Munster, IN 46321
6375 US Highway 6
Ste A
Portage, IN 46368
1771 Morthland Dr
Valparaiso, IN 46385
Practitioners & affiliated clinicians
Practitioners 24
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Geriatric Medicine (Family Medicine) Physician
- Crown Point, IN
- NPI 1851702229
IN
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1194393600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1776988800000",
"number": "1003096900",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 736895",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606736895",
"telephone_number": "219-922-8051",
"fax_number": "219-922-8608"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9410 CALUMET AVE STE 101",
"city": "MUNSTER",
"state": "IN",
"postal_code": "463212812",
"telephone_number": "219-922-8051",
"fax_number": "219-922-8608"
}
],
"practiceLocations": [
{
"address_1": "6625 W Lincoln Hwy",
"address_purpose": "LOCATION",
"city": "Crown Point",
"state": "IN",
"postal_code": "463079678",
"country_code": "US",
"telephone_number": "219-922-8051",
"fax_number": "219-922-8608",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1275 E North St Ste 102",
"address_purpose": "LOCATION",
"city": "Crown Point",
"state": "IN",
"postal_code": "463073541",
"country_code": "US",
"telephone_number": "219-922-8051",
"fax_number": "219-922-8608",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "DR MARY TILAK PC",
"organizational_subpart": "NO",
"enumeration_date": "2007-11-07",
"last_updated": "2026-04-24",
"certification_date": "2026-04-24",
"status": "A",
"authorized_official_last_name": "TILAK",
"authorized_official_first_name": "MARY",
"authorized_official_middle_name": "N.",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "219-922-8051",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "207RB0002X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Internal Medicine, Obesity Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "000000541656",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS",
"identifier": "90001352",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Munster, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.