DR MARY TILAK PC
NPI 1003096900
Internal Medicine - Obesity Medicine in Munster, IN

Q: What is Dr Mary Tilak PC's NPI number?

The NPI number for Dr Mary Tilak PC is 1003096900. It was assigned to this organization in the NPPES registry on November 7, 2007.

Q: What is Dr Mary Tilak PC's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Obesity Medicine, with taxonomy code 207RB0002X.

Q: When was this NPI record last updated?

The NPPES record for Dr Mary Tilak PC was last updated on April 24, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since November 07, 2007CLIA Certified · 3 labs

9410 CALUMET AVE STE 101, MUNSTER, IN 46321(219) 922-8051(219) 922-8608 Get Directions Write a Review

NPPES record last updated: April 24, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About Dr Mary Tilak Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR MARY TILAK PC (NPI 1003096900) is a healthcare organization registered as an obesity medicine in Munster, Indiana and active in the NPI registry since November 2007. The organization holds 3 active CLIA laboratory certificates, maintains 2 additional practice locations, and lists Mary N. Tilak, President, as its authorized official.

NPPES Registry Identity

NPI1003096900

Entity TypeOrganization

Primary Taxonomy207RB0002X

Legal Business NameDR MARY TILAK PC

Location Address9410 CALUMET AVE STE 101Munster, IN 46321-2812

Mailing AddressPo Box 736895Chicago, IL 60673-6895 · (219) 922-8051 · Fax (219) 922-8608

Phone(219) 922-8051

Fax(219) 922-8608

Organization SubpartNo

Authorized OfficialMary N. TilakPresident · (219) 922-8051

Enumeration DateNovember 7, 2007

Last NPPES UpdateApril 24, 2026

NPPES CertifiedApril 24, 2026

✔ NPI 1003096900 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Obesity MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207RB0002X

Definition

An internal medicine physician who specializes in the treatment of obesity demonstrates competency in and a thorough understanding of the treatment of obesity and the genetic, biologic, environmental, social, and behavioral factors that contribute to obesity. The obesity medicine physician employs therapeutic interventions including diet, physical activity, behavioral change, and pharmacotherapy. The obesity medicine physician utilizes a comprehensive approach, and may include additional resources such as dietitians, exercise physiologists, mental health professionals and bariatric surgeons as indicated to achieve optimal results. Additionally, the obesity medicine physician maintains competency in providing pre- peri- and post-surgical care of bariatric surgery patients, promotes the prevention of obesity, and advocates for those who suffer from obesity.

9410 CALUMET AVE STE 101, Munster, IN 46321

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Secondary Practice Locations 2

Location 16625 W Lincoln HwyCrown Point, IN 46307-9678 · Phone (219) 922-8051 · Fax (219) 922-8608

Location 21275 E North St Ste 102Crown Point, IN 46307-3541 · Phone (219) 922-8051 · Fax (219) 922-8608

Other Identifiers 2

Other000000541656IN · Anthem

Other90001352IL · Bc/bs

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health.Insurance ›

CLIA Laboratory Certificates CMS CLIA 3

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 15D2339231

Mary Tilak PC · Crown Point, IN

Active · expires Feb 25, 2028

CLIA Number15D2339231

Laboratory TypePhysician Office

Certificate Effective DateFebruary 26, 2026

Certificate Expiration DateFebruary 25, 2028

Laboratory DirectorDiane Orosz

Laboratory Phone(219) 922-8051

Laboratory LocationMary Tilak PC1275 E North Street Suite 102, Crown Point, IN 46307

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 15D1035173

Dr Mary Tilak PC · Munster, IN

Active · expires Dec 21, 2026

CLIA Number15D1035173

Laboratory TypePhysician Office

Certificate Effective DateDecember 22, 2024

Certificate Expiration DateDecember 21, 2026

Laboratory DirectorMary Tilak

Laboratory Phone(219) 922-8051

Laboratory LocationDr Mary Tilak PC9410 Calumet Ave Suite 101, Munster, IN 46321

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 15D2021147

Dr Mary Tilak PC · Crown Point, IN

Active · expires Mar 6, 2027

CLIA Number15D2021147

Laboratory TypePhysician Office

Certificate Effective DateMarch 7, 2025

Certificate Expiration DateMarch 6, 2027

Laboratory DirectorMary Tilak

Laboratory Phone(219) 922-1100

Laboratory LocationDr Mary Tilak PC6625 W Lincoln Hwy, Crown Point, IN 46307

CLIA data matches this NPI record on: Address Name

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KONSTANTINA GARDIKIOTES NP

Nurse Practitioner (Family)