Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Northshore Health Centers, Inc

Organization Family Medicine Physician · NPI 1972895647

Northshore Health Centers, Inc is a Family Medicine Physician in Lake Station, Indiana. Registered with an NPI since 2011.

In the registry since
2011
Specialties on file
4
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

3304 Parkside Ave
Lake Station, IN 46405-1143
Phone: (219) 763-8112
Fax: (219) 962-1860
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Federally Qualified Health Center (FQHC) (primary) Taxonomy 261QF0400X
Family Medicine Physician Taxonomy 207Q00000X
Nurse Practitioner Taxonomy 363L00000X
Family Nurse Practitioner Taxonomy 363LF0000X

Record details

NPI number1972895647
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official David Hall — Ceo · (219) 763-8112
Other names Northshore Edison Senior High School; Northshore Edison Senior High School
NPI enumeratedMay 12, 2011
Last updated in NPPESSeptember 22, 2020
Certification dateSeptember 22, 2020
Mailing addressPo Box 1430, Portage, IN 46368-9230

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