Search › Indiana › 363L00000X

Jennifer Defauw

NPI 1548982812 · on the registry since 2022

Practice

Address
3156 Willowcreek Rd
Portage, IN 46368
Phone
(219) 762-9444
Fax
(219) 762-2288
Organisation at this address
Bush Md Pc
J S Midmore Md Pc
Robert T. Ang, M.D.
Willow Creek Medical Llc
Medical Associates Of Nwi Llc
Inferred from a shared address, not stated in the registry.
Clinicians at this address
7

Additional practice sites

  • 1101 Glendale Blvd # 102a, Valparaiso, IN

Registry record

Primary taxonomy
363L00000X
363L00000X
Licence states on file
IN
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2026-06-19

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Indiana