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Active NPI 1043424740 Individual Practitioner Male Practitioner

Mark Ambrose , PA-C

Physician Assistant • Hazel Crest, IL

Professional Overview & Biography Verified Profile Summary

Mark Ambrose, PA-C is a registered healthcare professional specializing in Physician Assistant in Hazel Crest, IL. Practice services are available at 3330 W 177TH ST under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

3330 W 177th St
Suite 3e

Hazel Crest, IL 604292184

Telephone 7082060010
Fax 7082060020
Associated Practice Facility / Clinic
🏢 Geri-Med Service Ltd Facility NPI 1093775546

Specialty Benchmarks & Practice Insights

Comparative analytics for Physician Assistant in Hazel Crest, IL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 9.2 Yrs
State Avg: 11.7 Yrs
Regional Practice Density
9 Specialists

Practicing in Hazel Crest, IL (4958 Statewide)

Telehealth Adoption Rate
22.2% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

State License IL 085000830

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Additional State Medicaid & Healthcare Payer Identifiers

Commercial Insurance / Payer ID Provider No.
K18310SC (IL)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

30 Associated Practitioners
Dr. Kathleen Oshea-Wilk , MD

Internal Medicine - Geriatric Medicine

NPI 1013923689

Doctor of Medicine (M.D.)

Vienne Reid , LCSW

Social Worker - Clinical

NPI 1073916888

Licensed Clinical Social Worker

NPI 1114982477

Doctor of Medicine (M.D.)

Mia Garmon

Registered Nurse

NPI 1134546906
Susan Zeitner , LCSW

Social Worker - Clinical

NPI 1174861736

Licensed Clinical Social Worker

Dr. David Wilk , MD

Internal Medicine - Geriatric Medicine

NPI 1184630626

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active May 13, 2016

NPI status registered as active in NPPES database

📍
Updated Practice Location May 13, 2016

Registered at 3330 W 177TH ST, SUITE 3E, HAZEL CREST, IL 604292184 (Tel: 7082060010)

📍
Updated Business Mailing Address May 13, 2016

Registered at 16450 104TH AVE, STE 101, ORLAND PARK, IL 604675416 (Tel: 7082060010)

👤
Provider Name / Credentials Updated May 13, 2016

Recorded as MARK AMBROSE, PA-C

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) May 13, 2016

Physician Assistant (License #085000830 in IL)

🟢
Initial NPI Registration & Enumeration May 10, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1043424740
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: May 10, 2007
Last Update: May 13, 2016
Sole Proprietor: No

Mailing Address

16450 104th Ave, Ste 101

Orland Park, IL 604675416

Phone: 7082060010

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.