1659380889 NPI number — DR. LOUIS A GLUEK MD

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1659380889 NPI number — DR. LOUIS A GLUEK MD

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

GLUEK

Provider First Name:

LOUIS

Provider Middle Name:

A

Provider Name Prefix Text:

DR.

Provider Name Suffix Text:

Provider Credential Text:

MD

Provider Gender Code:

M

Provider Other Organization Name:

Provider Other Organization Name Type Code:

Provider Other Last Name:

Provider Other First Name:

Provider Other Middle Name:

Provider Other Name Prefix Text:

Provider Other Name Suffix Text:

Provider Other Credential Text:

Provider Other Last Name Type Code:

NPI Number:

1659380889

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

11/30/2011

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

PO BOX 3329

Provider Second Line Business Mailing Address:

Provider Business Mailing Address City Name:

MUNSTER

Provider Business Mailing Address State Name:

IN

Provider Business Mailing Address Postal Code:

46321-3329

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

219-934-2652

Provider Business Mailing Address Fax Number:

219-934-2658

Provider First Line Business Practice Location Address:

730 45TH STREET

Provider Second Line Business Practice Location Address:

Provider Business Practice Location Address City Name:

MUNSTER

Provider Business Practice Location Address State Name:

IN

Provider Business Practice Location Address Postal Code:

46321-2818

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

219-924-3300

Provider Business Practice Location Address Fax Number:

219-934-2658

Provider Enumeration Date:

08/05/2006

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 207X00000X , with the licence number:  01033299A , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: 200135850A . This is a "MEDICAID IN GROUP" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
• Identifier: 874640 . This is a "MEDICARE GROUP" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
• Identifier: 000000104771 . This is a "ANTHEM GROUP" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
• Identifier: 90000692 . This is a "BCIL GROUP" identifier . This identifiers is of the category "OTHER".
• Identifier: 129555400 . This is a "US DEPT LABOR GROUP" identifier . This identifiers is of the category "OTHER".
• Identifier: 001033299 . This is a "BCIL GLUEK" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
• Identifier: 092097 . This is a "ANTHEM DR GLUEK" identifier . This identifiers is of the category "OTHER".
• Identifier: 100354260A , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
• Identifier: 4204310 . This is a "AETNA DR GLUEK" identifier . This identifiers is of the category "OTHER".
• Identifier: 900764 . This is a "UNITED HLTHCARE DR GLUEK" identifier . This identifiers is of the category "OTHER".
• Identifier: 20411 . This is a "FIRST HEALTH DR GLUEK" identifier . This identifiers is of the category "OTHER".
• Identifier: 90000692 . This is a "BCIL GROUP" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
• Identifier: CI3318 . This is a "RR MEDICARE GROUP" identifier . This identifiers is of the category "OTHER".