NPIMap

Organization Active NPI

Informe HC Specialists, LLC

  • Internal Medicine Physician
  • Dyer, IN
National Provider Identifier
1255917647
Registry record updated Mar 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
INFORME HC SPECIALISTS, LLC
Practice address
2300 Great Lakes Dr
Dyer, IN 46311-1917
Phone
(219) 322-3555
Fax
(888) 724-0875
NPI assigned
Mar 24, 2021
Last updated
Mar 24, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jodi CzernejewskiNPI 1982969812
Title
Ceo
Phone
(414) 242-5468

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU
Internal Medicine Physician 207R00000X NU Primary
Infectious Disease Physician 207RI0200X NU
Sleep Medicine (Internal Medicine) Physician 207RS0012X NU
Hospice and Palliative Medicine (Family Medicine) Physician 207QH0002X NU
Hospice and Palliative Medicine (Internal Medicine) Physician 207RH0002X NU

Addresses

Primary practice location

2300 Great Lakes Dr
Dyer, IN 46311-1917

Mailing address

2741 W Layton Ave Ste 106
Milwaukee, WI 53221-2600
Phone (414) 242-5468

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, IL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20210428002612 IN Part B Supplier - Clinic/Group Practice 5698184885 Receives reassigned benefits from 12 practitioners
Practice locations: South Bend, IN; Mishawaka, IN; Merrillville, IN; Indianapolis, IN; Greenfield, IN; Gary, IN; Fishers, IN
O20210913001983 IL Part B Supplier - Clinic/Group Practice 5698184885 Receives reassigned benefits from 1 practitioner
Practice locations: Chicago, IL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 18

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 18

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1616544000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616544000000",
    "number": "1255917647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2741 W LAYTON AVE STE 106",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532212600",
            "telephone_number": "414-242-5468",
            "fax_number": "888-724-0875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 GREAT LAKES DR",
            "city": "DYER",
            "state": "IN",
            "postal_code": "463111917",
            "telephone_number": "219-322-3555",
            "fax_number": "888-724-0875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INFORME HC SPECIALISTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-24",
        "last_updated": "2021-03-24",
        "certification_date": "2021-03-24",
        "status": "A",
        "authorized_official_last_name": "CZERNEJEWSKI",
        "authorized_official_first_name": "JODI",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "414-242-5468"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207QH0002X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Hospice and Palliative Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dyer, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.