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MARK K CHANG MD NPI 1053579912


NPI Information

NPI: 1053579912
Provider Name: MARK K CHANG MD

Doing Business As: MIDWEST SPINECARE

Classification: Orthopaedic Surgery - 207XS0117X
Entity Type: Organization

Specialization: Orthopaedic Surgery of the Spine

Address:
1100 JOLIET ST
SUITE 104
DYER, IN
ZIP 46311
Phone: (219) 836-4955
Get Directions

MARK K CHANG MD is an orthopaedic surgery of the spine orthopaedic surgery in Dyer, IN. The provider is recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, orthopaedic surgeons of the spine deal with the evaluation and nonoperative and operative treatment of the full spectrum of primary spinal disorders including trauma, degenerative, deformity, tumor, and reconstructive. MARK K CHANG MD NPI is 1053579912. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Midwest Spinecare.

The provider's business location address is:

1100 JOLIET ST
SUITE 104
DYER, IN
ZIP 46311-996
Phone: (219) 836-4955

The provider's authorized official is Mark K Chang .
The authorized official title is Medical Director and has the following contact phone number (219) 836-4955.

The enumeration date for this NPI number is 5/28/2008 and was last updated on 1/12/2015.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207XS0117XOrthopaedic SurgeryOrthopaedic Surgery of the Spine036095817ILLINOISYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
15930340001OTHERILLINOISRR MEDICARE
203609507MEDICAIDILLINOIS
3215218MEDICARE PINILLINOIS
45930340001MEDICARE NSCILLINOIS
5G45938MEDICARE UPIN
6IN2023MEDICARE OSCAR/CERTIFICATIONINDIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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