Individual provider · Type 1 NPI

Mackenzie Rae Ketterhagen, PA-C

Surgical Physician Assistant · Chesterton, IN

NPI number 1821979519 Active

Practice location

601 Gateway Blvd N
Chesterton, IN 46304-9658

Call (219) 921-1444 Map

Fax (219) 921-5303

Other practice locations

  • 500 E 109th Ave, Crown Point, IN 46307-7294 · (219) 921-1444
  • 3691 Willowcreek Rd, Portage, IN 46368-5080 · (219) 921-1444
  • 833 W Lincoln Hwy Ste 110E, Schererville, IN 46375-4606 · (219) 921-1444

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant 363A00000XNone listed
Surgical Physician Assistant Primary 363AS0400XNone listed

Surgical Physician Assistant: Definition to come...

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About NPI 1821979519

Mackenzie Rae Ketterhagen, PA-C's National Provider Identifier is 1821979519, issued on Sep 9, 2025. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Chesterton, IN. The record was last updated on Sep 9, 2025.