Basic Information
Provider Information
NPI: 1649283086
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: YLAGAN
FirstName: LUIS
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 541 OTIS BOWEN DR
Address2:  
City: MUNSTER
State: IN
PostalCode: 463214158
CountryCode: US
TelephoneNumber: 2199345300
FaxNumber: 2199345389
Practice Location
Address1: 814 LAPORTE AVE
Address2:  
City: VALPARAISO
State: IN
PostalCode: 463835860
CountryCode: US
TelephoneNumber: 2199345300
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/15/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000X01022909INY Allopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


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