JOHN B MCCLELLAN III (NPI# 1710974472) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710974472 |
| Entity Type | Individual |
| Full Name | JOHN B MCCLELLAN III |
| Credential | M.D. |
| Practice Address |
5540 W 111th St Oak Lawn IL 60453-5574 |
| Practice Telephone | 7084238440 |
| Practice Fax Number | 7086582962 |
| Mailing Telephone | 7084238440 |
| Mailing Fax Number | 7086582962 |
| Enumeration Date | 2005-09-28 |
| Last Update Date | 2016-03-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207X00000X | Orthopaedic Surgery | 036055747 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | MEDICARE PTAN -SPI | F400279788 | 01 |
| IL | BCBS | 01623030 | 01 |
| IL | 036055747 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578526554 | John W Mcclellan Jr. | Family Medicine | 1015 N Elm St, Henderson, KY 42420-2712 | 2006-04-10 |
| 1932510039 | John Mcclellan Jr. | Counselor | 1101 E Washington Ave, Mcalester, OK 74501-4919 | 2014-05-13 |
| 1245674225 | John M Mcclellan | Surgery | Madigan Army Medical Center 9040 Jackson Avenue, Tacoma, WA 98431-1000 | 2013-04-22 |
| 1821192055 | John Kramer Mcclellan | Pharmacist | 1 W Main St, New Bloomfield, PA 17068-0038 | 2006-09-08 |
| 1114920592 | John William Mcclellan IIi | Orthopaedic Surgery | 13616 California St, Ste 100, Omaha, NE 68154-5335 | 2005-05-31 |
| Street Address |
5540 W 111TH ST |
| City | OAK LAWN |
| State | IL |
| Zip Code | 60453-5574 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 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 |
| 1023138633 | Chicago South Orthopedics, Inc | Specialist | 5540 W 111th St, Oak Lawn, IL 60453-5574 | 2007-03-29 |
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| 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 |
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| Taxonomy Code | 207X00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| 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. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306136668 | Emily Meredith Mayekar | Orthopaedic Surgery | 4220 W 95th St Ste 100, Oak Lawn, IL 60453 | 2011-04-07 |
| 1730133711 | Salman A Chaudri | Orthopaedic Surgery | 9618 Southwest Highway, Oak Lawn, IL 60453-2862 | 2006-05-22 |
| 1790737021 | Daniel Anthony Troy | Orthopaedic Surgery | 6701 W 95th St, Oak Lawn, IL 60453-2105 | 2006-05-16 |
| 1144285909 | Harun Durudogan | Orthopaedic Surgery | 9618 Southwest Hwy, Oak Lawn, IL 60453-2862 | 2006-04-17 |
| 1124461322 | Ivan Eck | Orthopaedic Surgery | 9618 Southwest Hwy, Oak Lawn, IL 60453-2862 | 2013-04-08 |
| 1689734881 | Prasad Gourineni M.d.s.c. | Orthopaedic Surgery | 4440 W.95th Street, Pediatric Ambulatory Clinic, Oak Lawn, IL 60453 | 2006-12-11 |
| 1205880317 | Jose R. Perez-sanz | Orthopaedic Surgery | 6701 W 95th St, Suite 6581, Oak Lawn, IL 60453-2105 | 2006-05-22 |
| 1144274606 | Southwest Orthopedics, S.c. | Orthopaedic Surgery | 9618 Southwest Hwy, Oak Lawn, IL 60453-2862 | 2006-05-20 |
| 1619966561 | David Joseph Smith | Orthopaedic Surgery | 5540 W 111th St, Oak Lawn, IL 60453-5574 | 2005-10-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144834680 | Illinois Bone and Joint Institute LLC | Orthopaedic Surgery | 1200 S York St Ste 4110, Elmhurst, IL 60126-5630 | 2020-09-02 |
| 1790303725 | Illinois Bone and Joint Institute LLC | Orthopaedic Surgery | 1009 Il Route 22 Ste 2, Fox River Grove, IL 60021-1998 | 2020-07-07 |
| 1104440049 | Elliot M Johns | Orthopaedic Surgery | 301 N 8th St Ste 3a158, Springfield, IL 62701-1085 | 2020-06-06 |
| 1740804764 | David Alan Forgas | Orthopaedic Surgery | 901 N 1st St # D252, Springfield, IL 62702-3759 | 2020-06-05 |
| 1700417185 | Illinois Bone and Joint Institute, LLC | Orthopaedic Surgery | 1890 Silver Cross Blvd # A, New Lenox, IL 60451-9524 | 2020-02-04 |
| 1588207799 | Illinois Bone and Joint Institute, LLC | Orthopaedic Surgery | 2719 W Algonquin Rd, Algonquin, IL 60102-9400 | 2019-10-21 |
| 1669020848 | Illinois Bone and Joint Institute, LLC | Orthopaedic Surgery | 406 Front St Ste 100, Mchenry, IL 60050-5593 | 2019-08-30 |
| 1790342194 | Kevin James Rasuli | Orthopaedic Surgery | 1611 W Harrison St. Ste. 400, Chicago, IL 60612 | 2019-05-22 |
| 1134680713 | Madeline Shaoyun Tiee | Orthopaedic Surgery | Loyola University Medical Center, 2160 S 1st Ave, Maywood, IL 60153 | 2019-03-27 |
| 1538629746 | Michael Murphy | Orthopaedic Surgery | 2160 S 1st Ave., Maguire Center, Dept of Ortho Surg, Maywood, IL 60153 | 2019-03-22 |
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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.