Lackman-Chuppe, Jennifer L.

Lackman-Chuppe, Jennifer L. is an individual health care provider with primary practice located at 615 N Michigan St , South Bend IN 46601-1087. She recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as her primary health care specialty. Lackman-Chuppe, Jennifer L. can be contacted via phone (574) 647-7459.

Contact Information

Primary practice address
615 N Michigan St South Bend IN 46601-1087
Phone: (574) 647-7459
Fax: (574) 647-3658
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 01037290 Indiana

Profile Details

NPI number 1568428019
LBN Legal business name Lackman-Chuppe, Jennifer L.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 25th, 2006
Last updated Dec 12th, 2018 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1568428019 NPPES
Indiana Other 930101010 RAIL ROAD MEDICARE
Indiana Other 000000181682 RAIL ROAD MEDICARE
Indiana MEDICAID 104340074 RAIL ROAD MEDICARE
Indiana MEDICAID 100091200 RAIL ROAD MEDICARE

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