CHICAGO SOUTH ORTHOPEDICS, INC (NPI# 1023138633) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023138633 |
| Entity Type | Organization |
| Organization Name | CHICAGO SOUTH ORTHOPEDICS, INC |
| Practice Address |
5540 W 111th St Oak Lawn IL 60453-5574 |
| Practice Telephone | 7084238440 |
| Practice Fax Number | 7086582958 |
| Mailing Telephone | 7084238440 |
| Mailing Fax Number | 7086582958 |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2020-05-21 |
| Authorized Official Name | MR. MARK R NIKKEL (ORTHOPEDIC SURGEN) |
| Authorized Official Telephone | 7084238440 |
| Authorized Official Credential | D.O. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | IL | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | BCBS | 31622992 | 01 |
| IL | SSN | $$$$$$$$$ | 01 |
| IL | NPI # INDIV. | 1699762336 | 01 |
| Street Address |
5540 W 111TH ST |
| City | OAK LAWN |
| State | IL |
| Zip Code | 60453-5574 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710974472 | John B Mcclellan IIi | Orthopaedic Surgery | 5540 W 111th St, Oak Lawn, IL 60453-5574 | 2005-09-28 |
| 1952554099 | Melissa Lee Duckett | Physical Therapy Assistant | 5540 W 111th St, Oak Lawn, IL 60453-5574 | 2008-11-03 |
| 1285887315 | Denise Joy Voss | Physical Therapy Assistant | 5540 W 111th St, Oak Lawn, IL 60453-5574 | 2008-11-03 |
| 1356594485 | Susan Marie Alexander | Physical Therapy Assistant | 5540 W 111th St, Oak Lawn, IL 60453-5574 | 2008-11-03 |
| 1366695405 | Theresa Marie Mccollom | Physical Therapy Assistant | 5540 W 111th St, Oak Lawn, IL 60453-5574 | 2008-11-03 |
| 1023261161 | Martha Lynn Coate | Physical Therapy Assistant | 5540 W 111th St, Oak Lawn, IL 60453-5574 | 2008-11-03 |
| 1922251966 | Jason D Lucci | Physical Therapist | 5540 W 111th St, Oak Lawn, IL 60453-5574 | 2008-11-03 |
| 1487844429 | Marc A. Cecchini | Physical Therapist | 5540 W 111th St, Oak Lawn, IL 60453-5574 | 2007-07-26 |
| 1619181625 | Sharon D Rasmussen | Physician Assistant | 5540 W 111th St, Oak Lawn, IL 60453-5574 | 2007-05-09 |
| 1124148739 | Medical Alliance for Corrective and Reconstructive Orthopedic Surgery | Specialist | 5540 W 111th St, Oak Lawn, IL 60453-5574 | 2007-03-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659995231 | Natalia Zero | Student in an Organized Health Care Education/Training Program | 4440 W 95th St, Rm 131 North, Oak Lawn, IL 60453 | 2020-05-30 |
| 1114554300 | Sylvia Maria Chlebek | Student in an Organized Health Care Education/Training Program | Advocate Christ Medical Center 4440 W. 95th St., Rm 131 North, Oak Lawn, IL 60453 | 2020-03-26 |
| 1972066751 | Amanda Mroczek | Family Medicine | 9555 52nd Avenue, Suite F, Oak Lawn, IL 60453 | 2019-04-09 |
| 1013479955 | Leah Rae Prager | Physician Assistant | 4400 W. 95th St., Attn: Pediatric General Surgery, Oak Lawn, IL 60453 | 2019-04-01 |
| 1659833473 | Chelsea Sumida Gipson | Family Medicine | 9555 South 52nd Avenue, Suite F, Oak Lawn, IL 60453 | 2019-04-01 |
| 1518427418 | Robert Lindgren | Family Medicine | 9555 S. 52nd Ave., Suite F, Oak Lawn, IL 60453 | 2019-03-25 |
| 1154886695 | Stephanie Anne Comer | Social Worker | 10102 South Cicero Avenue, Suite C, Oak Lawn, IL 60453 | 2019-02-08 |
| 1700360070 | Brian L Lee | Counselor | 8938 S Ridgeland Avenue Suite 100, Oak Lawn, IL 60453 | 2018-09-21 |
| 1679085245 | International Dental of Oak Lawn | Clinic/Center | 9539 S Cicero Ave, Oak Lawn, IL 60453 | 2017-11-03 |
| 1124538301 | Kavitha Rajendran | Physician Assistant | 5851 W. 95th Street, Suite 300, Oak Lawn, IL 60453 | 2017-10-02 |
| Find all providers in zip 60453 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023225331 | Southwest Hematology-oncology Consultant, Sc | Specialist | 6419 West 87th St, Oak Lawn, IL 60453 | 2007-05-17 |
| 1811027808 | Southwest Medical Specialists, Sc | Specialist | 6311 W 95th Street, Oak Lawn, IL 60453-2201 | 2007-03-07 |
| 1902986961 | Vinod Upadhyaya | Specialist | 4400 W 95th St Ste 201, Oak Lawn, IL 60453-2657 | 2006-10-16 |
| 1598845554 | Varsha Upadhyaya | Specialist | 4400 W 95th St Ste 202, Oak Lawn, IL 60453-2657 | 2006-10-16 |
| 1548224306 | Raj R Mittal | Specialist | 6419 W 87th St, Suite 1, Oak Lawn, IL 60453-1072 | 2006-04-17 |
| 1659344778 | Sara Ann Barr | Specialist | 9634 S Pulaski Rd, Oak Lawn, IL 60453-3391 | 2006-02-09 |
| 1194711655 | Retina Vitreous Associates, PC | Specialist | 4930 W 95th St, Oak Lawn, IL 60453-2504 | 2005-09-21 |
| 1457359697 | Charles Berkelhammer | Specialist | 9921 Southwest Hwy, Oak Lawn, IL 60453-3767 | 2005-07-12 |
| 1366445678 | Richard Z Belch | Specialist | 4400 W 95th St, Suite 207, Oak Lawn, IL 60453-2654 | 2005-05-31 |
| 1134531973 | Southside Pain Relief Center Inc | Specialist | 5569 W 95th St, Oak Lawn, IL 60453-2356 | 2014-05-28 |
| Find all providers in OAK LAWN | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.