Dermatology Center of Northwest Indiana LLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

DERMATOLOGY CENTER OF NORTHWEST INDIANA LLC

Practice address

70 W 94TH PL
Crown Point, IN 46307-1710

Phone

(219) 662-8822

Fax

(219) 662-8833

NPI assigned

May 24, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Mitchell L Bressack, MD

Title

Owner

Phone

(219) 662-8856

Specialties & licenses 2

Addresses

Other names 1

• Dermatology Center of Northwest Indiana Doing business as

Locations

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

{
    "created_epoch": "1306195200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1306195200000",
    "number": "1609169671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 W 94TH PL",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463071710",
            "telephone_number": "219-662-8822",
            "fax_number": "219-662-8833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 W 94TH PL",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463071710",
            "telephone_number": "219-662-8822",
            "fax_number": "219-662-8833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMATOLOGY CENTER OF NORTHWEST INDIANA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-24",
        "last_updated": "2011-05-24",
        "status": "A",
        "authorized_official_last_name": "BRESSACK",
        "authorized_official_first_name": "MITCHELL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "219-662-8856",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, Dermatopathology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dermatology Center of Northwest Indiana",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Amy Delturco
• Kyle Iona Demyer, NURSE PRACTITIONER
• Christina Dennie, FNP-C
• Dental Center (Crown Point) P.C.
• James Denton, R.PH.
• Dermatology Center of Northwest Indiana, PC
• Julie Ann Derosa, M.D.
• Tapan Apurva Desai, MD
• Carmen Devenport, PHARMD
• Jamie Devries, LPC

• Dermatology Physician in Crown Point, IN
• Providers in Crown Point, IN by specialty
• Dermatology Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.