Chang, Mark K

Chang, Mark K is an sole proprietor health care provider with primary practice located at 1100 Joliet St Ste 104, Dyer IN 46311-1996. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as his primary health care specialty. Chang, Mark K can be contacted via phone (219) 836-4955.

Contact Information

Primary practice address
1100 Joliet St Ste 104 Dyer IN 46311-1996
Phone: (219) 836-4955
Fax: (219) 865-2377
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 200033540A Indiana
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 036095817 Illinois

Profile Details

NPI number 1871607507
LBN Legal business name Chang, Mark K
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 19th, 2006
Last updated Dec 13th, 2021 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1871607507 NPPES
Illinois MEDICAID 036095817
Illinois Other P00419910
Illinois MEDICAID 200868870A

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