Active NPI 1871607507 Individual Practitioner Male Practitioner

Dr. Mark K Chang , MD

Orthopaedic Surgery • Dyer, IN

✓ Accepts Medicare Assignment Telehealth Available

Professional Overview & Biography Verified Profile Summary

Dr. Mark Chang, MD is a certified Orthopaedic Surgery practicing in Dyer, IN. With approximately 36 years of clinical experience since graduating from Medical University Of South Carolina College Of Medicine in 1990, Dr. Chang delivers high-quality medical care to the local community at 1100 JOLIET ST.

Dr. Chang accepts Medicare assignment . Telehealth and virtual consultation options are available for eligible patients.

Frequently performed procedures and clinical services include established patient outpatient office visit, x-ray of lower and sacral spine, 2-3 views, telephone medical discussion with physician. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

1100 Joliet St
Ste 104

Dyer, IN 463111996

Telephone 2198364955

Fax 2198652377

Associated Practice Facility / Clinic

🏢 Mbwoude, Inc. Facility NPI 1497709950

Medicare Profile & Education

Medical School

Medical University Of South Carolina College Of Medicine

Graduation Year

1990

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

Telehealth Services Available

Specialty Benchmarks & Practice Insights

Comparative analytics for Orthopaedic Surgery in Dyer, IN

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

36 Yrs Matches City Avg

City Avg: 36.0 Yrs

State Avg: 26.1 Yrs

Regional Practice Density

1 Specialists

Practicing in Dyer, IN (530 Statewide)

Telehealth Adoption Rate

100.0% Regional Adoption

✓ Offers Virtual Consultations

Medicare Pricing Discount

94.7% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Chang (36 Years) 36 Yrs

Dyer Specialty Average (36.0 Years) 36.0 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	441	224	$114.00	$51.88
99213 Established patient office or other outpatient visit, typically 15 minutes	285	206	$173.00	$82.78
72100 X-ray of lower and sacral spine, 2-3 views	276	154	$192.00	$36.25
99441 Telephone medical discussion with physician, 5-10 minutes	104	39	$35.00	$34.57
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	78	78	$268.00	$100.53
72040 X-ray of upper spine, 2-3 views	70	36	$187.00	$35.81
99202 New patient office or other outpatient visit, typically 20 minutes	65	65	$173.00	$66.72
63047 Partial removal of middle spine bone with release of spinal cord and/or nerves	49	45	$20761.00	$721.68
99221 Initial hospital inpatient care per day, typically 30 minutes	40	39	$243.00	$82.94
99231 Follow-up hospital inpatient care per day, typically 15 minutes	35	21	$115.00	$49.65
63048 Partial removal of spine bone with release of spinal cord and/or nerves	32	22	$5136.25	$186.01
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	31	29	$253.00	$118.64
22842 Placement of stabilizing device to back, 3-6 spine bone segments	30	29	$13055.00	$671.79
99211 Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional	29	26	$50.00	$21.44
22612 Fusion of spine in lower back	22	20	$23934.00	$1342.17
72070 X-ray of middle spine, 2 views	19	18	$156.00	$28.48
22853 Insertion of cage or mesh device to spine bone and disc space during spine fusion	18	18	$7023.00	$240.32
22633 Fusion of spine in lower back with partial removal of spine bone and disc	15	15	$28006.00	$1722.39
63052 Partial removal of bone of single segment of spine in lower back with release of spinal cord and/or nerves during fusion of spine in lower back	13	13	$7321.00	$247.43
72170 X-ray of pelvis, 1-2 views	13	12	$210.00	$25.36
22850 Removal of stabilizing device from back of spine	12	11	$8798.00	$341.94

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	608	282	$114.00	$46.77
72100 X-ray of lower and sacral spine, 2-3 views	329	173	$192.00	$36.72
99213 Established patient office or other outpatient visit, typically 15 minutes	159	139	$173.00	$83.16
99441 Telephone medical discussion with physician, 5-10 minutes	118	49	$35.00	$34.39
99202 New patient office or other outpatient visit, typically 20 minutes	107	107	$173.00	$66.78
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	65	65	$268.00	$102.85
72040 X-ray of upper spine, 2-3 views	64	37	$187.00	$36.63
63047 Partial removal of middle spine bone with release of spinal cord and/or nerves	53	49	$20761.00	$863.77
99211 Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional	51	51	$50.00	$21.37
63048 Partial removal of spine bone with release of spinal cord and/or nerves	39	29	$5040.83	$192.75
99221 Initial hospital inpatient care per day, typically 30 minutes	39	36	$243.00	$80.74
72070 X-ray of middle spine, 2 views	32	30	$156.00	$29.43
22842 Placement of stabilizing device to back, 3-6 spine bone segments	31	31	$13055.00	$692.07
99231 Follow-up hospital inpatient care per day, typically 15 minutes	27	23	$115.00	$49.22
22853 Insertion of cage or mesh device to spine bone and disc space during spine fusion	25	25	$7023.00	$235.75
72170 X-ray of pelvis, 1-2 views	23	18	$210.00	$25.77
63052 Partial removal of bone of single segment of spine in lower back with release of spinal cord and/or nerves during fusion of spine in lower back	21	21	$7321.00	$234.13
22633 Fusion of spine in lower back with partial removal of spine bone and disc	21	21	$28006.00	$1647.84
63053 Partial removal of bone of additional segment of spine in lower back with release of spinal cord and/or nerves during fusion of spine in lower back	19	17	$5190.42	$204.80
20931 Donor bone graft for spine surgery	18	18	$1000.00	$100.51
63685 Insertion of spinal neurostimulator pulse generator or receiver	18	17	$4750.00	$170.00
22614 Fusion of additional segment of spine	16	11	$4304.69	$350.55
63655 Removal of spine bone for insertion of neurostimulator electrode plate in spine	16	16	$2456.00	$747.35
22612 Fusion of spine in lower back	15	15	$23934.00	$1497.72
22634 Fusion of additional segment of spine with partial removal of spine bone and disc	15	15	$8200.00	$434.71

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	454	249	$114.13	$47.26
72100 X-ray of lower and sacral spine, 2-3 views	285	163	$192.00	$36.33
99213 Established patient office or other outpatient visit, typically 15 minutes	253	182	$173.00	$82.34
99441 Telephone medical discussion with physician, 5-10 minutes	125	52	$35.00	$33.60
72040 X-ray of upper spine, 2-3 views	102	46	$187.00	$36.61
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	84	84	$268.00	$104.45
99202 New patient office or other outpatient visit, typically 20 minutes	71	71	$173.00	$67.85
63047 Partial removal of middle spine bone with release of spinal cord and/or nerves	66	62	$20761.00	$735.72
99211 Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional	52	52	$50.00	$21.47
63048 Partial removal of spine bone with release of spinal cord and/or nerves	49	35	$4650.97	$195.58
20931 Donor bone graft for spine surgery	34	34	$1000.00	$101.17
99231 Follow-up hospital inpatient care per day, typically 15 minutes	33	20	$115.00	$38.77
22842 Placement of stabilizing device to back, 3-6 spine bone segments	29	29	$13055.00	$725.28
99221 Initial hospital inpatient care per day, typically 30 minutes	27	24	$243.00	$99.18
22633 Fusion of spine in lower back with partial removal of spine bone and disc	24	24	$28006.00	$1689.93
72070 X-ray of middle spine, 2 views	20	14	$156.00	$30.63
22614 Fusion of additional segment of spine	20	11	$3733.75	$383.08
22853 Insertion of cage or mesh device to spine bone and disc space during spine fusion	18	18	$7023.00	$238.44
22612 Fusion of spine in lower back	15	15	$23934.00	$1486.34
72170 X-ray of pelvis, 1-2 views	15	13	$210.00	$25.82
22840 Placement of stabilizing device to back of 1 spine bone in neck	14	14	$11604.00	$660.16
22850 Removal of stabilizing device from back of spine	13	13	$8798.00	$333.35
22514 Injection of bone cement into body of lower spine bone accessed through the skin using imaging guidance	11	11	$21736.00	$453.35

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	450	243	$114.13	$47.23
72100 X-ray of lower and sacral spine, 2-3 views	277	153	$192.00	$35.89
99213 Established patient office or other outpatient visit, typically 15 minutes	214	153	$173.00	$84.61
99441 Telephone medical discussion with physician, 5-10 minutes	86	42	$35.00	$34.99
99202 New patient office or other outpatient visit, typically 20 minutes	82	82	$173.00	$67.10
63047 Partial removal of middle spine bone with release of spinal cord and/or nerves	72	64	$20761.00	$809.91
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	72	72	$268.00	$105.68
99231 Follow-up hospital inpatient care per day, typically 15 minutes	57	24	$115.00	$40.20
72040 X-ray of upper spine, 2-3 views	47	30	$187.00	$36.58
63048 Partial removal of spine bone with release of spinal cord and/or nerves	47	31	$4771.28	$190.12
99221 Initial hospital inpatient care per day, typically 30 minutes	41	40	$243.00	$104.61
99211 Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional	31	31	$50.00	$20.79
20931 Donor bone graft for spine surgery	29	29	$1000.00	$94.36
22842 Placement of stabilizing device to back, 3-6 spine bone segments	21	21	$13055.00	$669.71
22612 Fusion of spine in lower back	20	19	$23934.00	$1472.53
22853 Insertion of cage or mesh device to spine bone and disc space during spine fusion	17	17	$7023.00	$242.35
72170 X-ray of pelvis, 1-2 views	17	14	$210.00	$25.73
22850 Removal of stabilizing device from back of spine	14	13	$8798.00	$354.87
22633 Fusion of spine in lower back with partial removal of spine bone and disc	13	13	$28006.00	$1430.55
72070 X-ray of middle spine, 2 views	12	12	$156.00	$30.23
22840 Placement of stabilizing device to back of 1 spine bone in neck	12	11	$11604.00	$603.72
63685 Insertion of spinal neurostimulator pulse generator or receiver	11	11	$1068.00	$214.62
22859 Insertion of device into gap left by removal of part of vertebra	11	11	$4588.00	$311.66

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	328	224	$172.31	$70.36
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	271	166	$116.49	$42.62
72100 X-ray of lower and sacral spine, 2-3 views	268	157	$193.01	$34.94
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	108	108	$263.85	$98.15
63047 Partial removal of middle spine bone with release of spinal cord and/or nerves	66	64	$20761.00	$822.53
99441 Telephone medical discussion with physician, 5-10 minutes	62	33	$35.00	$34.95
72040 X-ray of upper spine, 2-3 views	54	34	$188.26	$35.35
99202 New patient office or other outpatient visit, typically 20 minutes	50	50	$179.80	$71.47
63048 Partial removal of spine bone with release of spinal cord and/or nerves	49	36	$5287.30	$203.96
99221 Initial hospital inpatient care per day, typically 30 minutes	48	46	$261.21	$105.70
99231 Follow-up hospital inpatient care per day, typically 15 minutes	46	29	$122.02	$41.12
20931 Donor bone graft for spine surgery	29	29	$969.28	$104.73
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	24	22	$253.00	$102.81
22842 Placement of stabilizing device to back, 3-6 spine bone segments	21	20	$13088.81	$745.60
22633 Fusion of spine in lower back with partial removal of spine bone and disc	20	20	$28051.75	$1863.61
22867 Insertion of stabilizing or separating device into lower spine at single level with open decompression	19	19	$13634.05	$501.49
22853 Insertion of cage or mesh device to spine bone and disc space during spine fusion	18	17	$6047.58	$250.62
72170 X-ray of pelvis, 1-2 views	14	13	$210.00	$24.43
22515 Treatment of broken spine bone with stabilizing device, each additional segment	14	11	$11957.68	$224.91
22514 Injection of bone cement into body of lower spine bone accessed through the skin using imaging guidance	12	11	$21248.25	$458.82

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	352	208	$126.95	$41.96
72100 X-ray of lower and sacral spine, 2-3 views	342	179	$194.96	$33.99
99213 Established patient office or other outpatient visit, typically 15 minutes	325	219	$170.66	$69.09
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	140	140	$251.91	$100.84
72040 X-ray of upper spine, 2-3 views	102	46	$190.92	$33.21
99231 Follow-up hospital inpatient care per day, typically 15 minutes	67	37	$131.69	$41.64
99202 New patient office or other outpatient visit, typically 20 minutes	63	63	$193.00	$71.88
63047 Partial removal of middle spine bone with release of spinal cord and/or nerves	53	49	$20761.00	$950.54
99221 Initial hospital inpatient care per day, typically 30 minutes	52	48	$288.62	$107.13
99211 Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional	48	23	$89.00	$21.39
63048 Partial removal of spine bone with release of spinal cord and/or nerves	42	27	$5690.99	$205.31
20931 Donor bone graft for spine surgery	39	39	$899.56	$113.26
22842 Placement of stabilizing device to back, 3-6 spine bone segments	31	30	$13197.00	$758.69
22853 Insertion of cage or mesh device to spine bone and disc space during spine fusion	30	28	$6437.75	$260.00
22633 Fusion of spine in lower back with partial removal of spine bone and disc	29	29	$28300.48	$1895.82
22867 Insertion of stabilizing or separating device into lower spine at single level with open decompression	23	23	$14932.00	$557.34
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	19	19	$253.00	$98.44
22850 Removal of stabilizing device from back of spine	19	19	$8798.00	$348.36
63685 Insertion of spinal neurostimulator pulse generator or receiver	18	17	$5802.00	$149.19
22514 Injection of bone cement into body of lower spine bone accessed through the skin using imaging guidance	17	16	$21290.00	$466.83
72020 X-ray of spine, 1 view	15	12	$150.00	$21.43
22840 Placement of stabilizing device to back of 1 spine bone in neck	15	14	$11722.53	$772.45
62362 Implantation or replacement of programmable spinal canal drug infusion pump	15	15	$8603.00	$159.91
63655 Removal of spine bone for insertion of neurostimulator electrode plate in spine	15	15	$16834.00	$539.04
22634 Fusion of additional segment of spine with partial removal of spine bone and disc	13	11	$7047.69	$511.60
22551 Fusion of upper spine bone with removal of disc and release of spinal cord or nerve, 1 disc	11	11	$26075.45	$1692.58

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	434	261	$127.00	$44.59
72100 X-ray of lower and sacral spine, 2-3 views	348	166	$195.00	$35.76
99213 Established patient office or other outpatient visit, typically 15 minutes	302	209	$164.93	$72.86
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	148	148	$252.00	$109.48
72040 X-ray of upper spine, 2-3 views	78	41	$191.00	$33.07
63047 Partial removal of middle spine bone with release of spinal cord and/or nerves	72	68	$20761.00	$892.69
99231 Follow-up hospital inpatient care per day, typically 15 minutes	59	37	$132.00	$45.57
63048 Partial removal of spine bone with release of spinal cord and/or nerves	56	38	$5831.26	$225.44
99221 Initial hospital inpatient care per day, typically 30 minutes	56	52	$292.79	$116.58
20931 Donor bone graft for spine surgery	45	45	$901.00	$117.91
99202 New patient office or other outpatient visit, typically 20 minutes	42	42	$193.00	$77.21
22842 Placement of stabilizing device to back, 3-6 spine bone segments	39	38	$13076.85	$816.93
99211 Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional	38	22	$89.00	$21.76
22867 Insertion of stabilizing or separating device into lower spine at single level with open decompression	33	32	$12533.09	$562.94
22614 Fusion of additional segment of spine	32	19	$5567.91	$428.46
22853 Insertion of cage or mesh device to spine bone and disc space during spine fusion	30	26	$5813.33	$255.58
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	27	27	$251.67	$111.32
22633 Fusion of spine in lower back with partial removal of spine bone and disc	26	26	$28052.92	$1920.30
22850 Removal of stabilizing device from back of spine	23	23	$8707.13	$385.93
22859 Insertion of device into gap left by removal of part of vertebra	22	22	$5172.00	$350.25
22830 Exploration of spinal fusion	19	19	$23222.32	$528.28
22612 Fusion of spine in lower back	18	18	$24195.00	$1645.88
22514 Injection of bone cement into body of lower spine bone accessed through the skin using imaging guidance	16	15	$23917.69	$465.90
22513 Treatment of broken middle spine bone with placement of stabilizing device using imaging guidance	16	15	$14774.00	$565.14
22840 Placement of stabilizing device to back of 1 spine bone in neck	16	16	$11731.00	$775.97
22551 Fusion of upper spine bone with removal of disc and release of spinal cord or nerve, 1 disc	12	12	$26101.00	$1608.57
22868 Insertion of stabilizing or separating device into lower spine at additional level with open decompression	11	11	$3735.00	$252.05

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	426	258	$127.00	$48.95
72100 X-ray of lower and sacral spine, 2-3 views	302	183	$195.00	$39.99
99213 Established patient office or other outpatient visit, typically 15 minutes	272	210	$162.00	$82.82
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	160	160	$252.00	$121.35
99231 Follow-up hospital inpatient care per day, typically 15 minutes	78	41	$132.00	$51.50
63047 Partial removal of middle spine bone with release of spinal cord and/or nerves	76	72	$20761.00	$923.05
99211 Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional	74	46	$89.00	$22.89
99221 Initial hospital inpatient care per day, typically 30 minutes	60	58	$289.00	$129.24
22867 Insertion of stabilizing or separating device into lower spine at single level with open decompression	55	54	$14932.00	$817.22
99202 New patient office or other outpatient visit, typically 20 minutes	54	54	$193.00	$83.84
72040 X-ray of upper spine, 2-3 views	52	33	$191.00	$37.13
63048 Partial removal of spine bone with release of spinal cord and/or nerves	34	22	$5495.32	$250.11
20931 Donor bone graft for spine surgery	33	33	$901.00	$135.86
22842 Placement of stabilizing device to back, 3-6 spine bone segments	28	27	$13197.00	$817.41
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	24	24	$235.00	$124.94
22853 Insertion of cage or mesh device to spine bone and disc space during spine fusion	23	18	$3735.39	$334.21
38220 Aspiration of bone marrow sample for diagnosis	23	22	$395.00	$36.52
22633 Fusion of spine in lower back with partial removal of spine bone and disc	22	22	$28311.00	$2051.53
22612 Fusion of spine in lower back	21	21	$24195.00	$1848.05
22859 Insertion of device into gap left by removal of part of vertebra	17	17	$5172.00	$340.66
72170 X-ray of pelvis, 1-2 views	17	16	$187.00	$36.27
22514 Injection of bone cement into body of lower spine bone accessed through the skin using imaging guidance	16	16	$23959.00	$608.75
22614 Fusion of additional segment of spine	16	13	$5980.34	$484.78
22830 Exploration of spinal fusion	15	15	$23462.00	$508.33
22634 Fusion of additional segment of spine with partial removal of spine bone and disc	15	14	$7380.50	$529.47
22850 Removal of stabilizing device from back of spine	14	14	$8798.00	$398.47

Medical Specialties & State Licenses

CMS Verified: 2025-02-05

Orthopaedic Surgery Primary Specialty

NUCC Taxonomy Code: 207X00000X

State License IL 036095817

An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.

Orthopaedic Surgery

NUCC Taxonomy Code: 207X00000X

State License IN 200033540A

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

036095817 (IL)

Medicaid State Provider ID

200868870A (IN)

Commercial Insurance / Payer ID Railroad Medicare

P00419910

Practice Associates & Co-Workers

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

8 Associated Practitioners

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Physical Therapist

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Dr. Sarah Martinez , DPT

Physical Therapist

NPI 1477801116

Doctor of Physical Therapy

Tara Pai , MSPT

Physical Therapist

NPI 1528014859

Master of Science in Physical Therapy

Dr. Sima Shah , DPT

Physical Therapist

NPI 1578503744

Doctor of Physical Therapy

Sara Stafford , PT

Physical Therapist

NPI 1669486833

Physical Therapist

Daniel Benjamin , PT

Physical Therapist

NPI 1699715615

Physical Therapist

Career & Practice History Timeline

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

6 Historical Events

✅

NPI Profile Active January 13, 2015

NPI status registered as active in NPPES database

📍

Updated Practice Location January 13, 2015

Registered at 1100 JOLIET ST, STE 104, DYER, IN 463111996 (Tel: 2198364955)

📍

Updated Business Mailing Address January 13, 2015

Registered at 1100 JOLIET ST, STE 104, DYER, IN 463111996 (Tel: 2198364955)

👤

Provider Name / Credentials Updated January 13, 2015

Recorded as MARK CHANG, M.D.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) January 13, 2015

Orthopaedic Surgery (License #036095817 in IL)

🟢

Initial NPI Registration & Enumeration August 19, 2006

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: 1871607507

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: August 19, 2006

Last Update: February 05, 2025

Sole Proprietor: Yes

Update or Correct Profile

Mailing Address

1100 Joliet St, Ste 104

Dyer, IN 463111996

Phone: 2198364955

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.