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MEDINA HEALTHCARE SC
NPI 1487975900
Internal Medicine in Dyer, IN

Active since June 18, 2010CLIA 14D0951889 · Waiver
932 RICHARD RD, DYER, IN 46311(219) 515-2148 Get Directions Write a Review

NPPES record last updated: December 5, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Dec 5, 2023, Nov 26, 2019 (2 updates tracked since 2019).

About Medina Healthcare Sc NPPES

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

MEDINA HEALTHCARE SC (NPI 1487975900) is a healthcare organization registered as an internal medicine in Dyer, Indiana and active in the NPI registry since June 2010. The organization holds a CLIA Waiver certificate valid through September 29, 2026 and lists Katie A Werner, Credentialing, as its authorized official.

NPPES Registry Identity

NPI1487975900
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameMEDINA HEALTHCARE SC
Location Address932 RICHARD RDDyer, IN 46311-1936
Mailing Address932 Richard RdDyer, IN 46311-1936 · (708) 982-1544 · Fax (219) 440-7312
Phone(219) 515-2148
Organization SubpartNo
Authorized OfficialKatie A WernerCredentialing · (630) 261-9286
Enumeration DateJune 18, 2010
Last NPPES UpdateDecember 5, 20232 updates tracked since enumeration
NPPES CertifiedDecember 5, 2023
✔ NPI 1487975900 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in IL · 036089606
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
932 RICHARD RD, Dyer, IN 46311
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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

CLIA Laboratory Certificates CMS CLIA

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 14D0951889

Medina Healthcare · Dyer, IN
Active · expires Sep 29, 2026
CLIA Number14D0951889
Laboratory TypeCommunity Clinic
Certificate Effective DateSeptember 30, 2024
Certificate Expiration DateSeptember 29, 2026
Laboratory DirectorHuma T. Mulk
Laboratory Phone(219) 515-2148
Laboratory LocationMedina Healthcare932 Richard Rd, Dyer, IN 46311
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

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

DR. HUMA TAZEEM MULK M.D.
Internal Medicine
932 RICHARD RD
DYER, IN 46311
Lake County (708) 982-1544

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Medina Healthcare Sc's NPI number?

The NPI number for Medina Healthcare Sc is 1487975900. It was assigned to this organization in the NPPES registry on June 18, 2010.

Where is Medina Healthcare Sc located?

Medina Healthcare Sc is located at 932 Richard Rd, Dyer, IN 46311. The listed phone number is (219) 515-2148.

What is Medina Healthcare Sc's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Does Medina Healthcare Sc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 14D0951889) is associated with this NPI, valid through September 29, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Medina Healthcare Sc was last updated on December 5, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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.