Mark H Gonzalez (NPI# 1104837475, PAC ID# 1153381280) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is ORTHOPEDIC SURGERY.
| Nation Provider ID (NPI) | 1104837475 |
| PAC ID by PECOS | 1153381280 |
| Professional Enrollment ID | I20041013001060 |
| Full Name | Mark H Gonzalez |
| Organization Legal Name | THE BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS |
| Address |
901 S Walcott St Uic Orthopedic Sports Medicine Chicago IL 60612-3725 |
| Phone Number | 3129967161 |
| Gender | M |
| Credential | MD |
| Medical School | UNIVERSITY OF CHICAGO, PRITZKER SCHOOL OF MEDICINE |
| Graduation Year | 1980 |
| Primary Specialty | ORTHOPEDIC SURGERY |
| Secondary Specialties | HAND SURGERY |
| Group Practice PAC ID | 3072422716 |
| Number of Group Practice Members | 792 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 140150 | UNIVERSITY OF ILLINOIS HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 2101 Waukegan Rd, Bannockburn, IL 60015-1836 | ILLINOIS BONE AND JOINT INSTITUTE LLC | |
| 150 N Michigan Ave, Suite 1400, Chicago, IL 60601-7568 | 3124441145 | ILLINOIS BONE AND JOINT INSTITUTE LLC |
| 1740 W Taylor St, Chicago, IL 60612-7232 | THE BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS | |
| 901 S Walcott St, Uic Orthopedic Sports Medicine, Chicago, IL 60612-3725 | 3129967161 | THE BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS |
| Organization Legal Name | THE BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS |
| Physicians | 919 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Joseph Karam | Orthopedic Surgery | The Board of Trustees of The University of Illinois | 835 S Wolcott Ave Mc, 844 Uic Orthopedics Sports Medicine, Chicago, IL 60612-3748 |
| Adam Kosloff | Internal Medicine | The Board of Trustees of The University of Illinois | 840 S Wood St Mc, 787 Uic Medicine, Chicago, IL 60612-4325 |
| Claire Thesing | Family Medicine | The Board of Trustees of The University of Illinois | 1919 W Taylor St, Suite 663, Chicago, IL 60612-7246 |
| Nicholas F Callahan | Maxillofacial Surgery | The Board of Trustees of The University of Illinois | 801 S Paulina St, Chicago, IL 60612-7210 |
| Ayman Al-hendy | Obstetrics/gynecology | The Board of Trustees of The University of Illinois | 820 S Wood St Mc, 808 Uic Obstetrics and Gynecology, Chicago, IL 60612-4325 |
| Mario Spaggiari | General Surgery | The Board of Trustees of The University of Illinois | 840 S Wood St, Uic Model Clinics, Chicago, IL 60612-4325 |
| Rayan A Elkattah | Obstetrics/gynecology | The Board of Trustees of The University of Illinois | 1 Illini Dr, Peoria, IL 61605-2576 |
| Jennifer Dugal | Nurse Practitioner | The Board of Trustees of The University of Illinois | 808 S Wood St Mc, 624 Uic Dermatology, Chicago, IL 60612-7300 |
| Katherine E Cappitelli | Nurse Practitioner | The Board of Trustees of The University of Illinois | 808 S Wood St, 722 Uic Emergency Medicine, Chicago, IL 60612-7300 |
| Robison Chan | Ophthalmology | The Board of Trustees of The University of Illinois | 1855 W Taylor St, Mc648, Chicago, IL 60612-7242 |
| Street Address |
901 S WALCOTT ST UIC ORTHOPEDIC SPORTS MEDICINE |
| City | CHICAGO |
| State | IL |
| Zip | 60612-3725 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Maria Siemionow | Orthopedic Surgery | The Board of Trustees of The University of Illinois | 901 S Walcott St, Uic Orthopedic Sports Medicine, Chicago, IL 60612-3725 |
| Benjamin Goldberg | Orthopedic Surgery | The Board of Trustees of The University of Illinois | 901 S Walcott St, Uic Orthopedic Sports Medicine, Chicago, IL 60612-3725 |
| Haluk Altiok | Orthopedic Surgery | The Board of Trustees of The University of Illinois | 901 S Walcott St, Uic Orthopedic Sports Medicine, Chicago, IL 60612-3725 |
| Adekunbi Costa | Nurse Practitioner | The Board of Trustees of The University of Illinois | 901 S Walcott St, Uic Orthopedic Sports Medicine, Chicago, IL 60612-3725 |
| Owen Barmada | Physician Assistant | The Board of Trustees of The University of Illinois | 901 S Walcott St, Uic Orthopedic Sports Medicine, Chicago, IL 60612-3725 |
| Edward M Abraham | Orthopedic Surgery | The Board of Trustees of The University of Illinois | 901 S Walcott St, Uic Orthopedic Sports Medicine, Chicago, IL 60612-3725 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Julie A Carbray | Nurse Practitioner | The Board of Trustees of The University of Illinois | 1747 W Roosevelt Rd, Chicago, IL 60612-1264 |
| Keith A La Vallee | Optometry | 2111 W Superior St, Chicago, IL 60612-1315 | |
| Ricky Johnson | Internal Medicine | 3169 W Madison St, Chicago, IL 60612-1809 | |
| Valerie L Wezran | Nurse Practitioner | Access Community Health Network | 2409 W Warren Blvd, Chicago, IL 60612-2115 |
| Shay L Ward | Nurse Practitioner | Housecall Physicians of Illinois Sc | 2003 W Fulton St, Suite 303, Chicago, IL 60612-2345 |
| Angie Wang | Registered Dietitian Or Nutrition Professional | Dietitians At Home Inc | 2003 W Fulton St, Suite 105, Chicago, IL 60612-2345 |
| Amanda Christine Harrington | Registered Dietitian Or Nutrition Professional | Dietitians At Home Inc | 2003 W Fulton St, Suite 105, Chicago, IL 60612-2345 |
| Rena Chaya Schwartz | Nurse Practitioner | Housecall Physicians of Illinois Sc | 2003 W Fulton St, Suite 303, Chicago, IL 60612-2345 |
| Alexia Boima Caulker | Registered Dietitian Or Nutrition Professional | Dietitians At Home Inc | 2003 W Fulton St, Suite 105, Chicago, IL 60612-2345 |
| Brian S Boe | Internal Medicine | Housecall Physicians of Illinois Sc | 2003 W Fulton St, Suite 303, Chicago, IL 60612-2345 |
| Find all physicians in zip 60612 | |||
| City | CHICAGO |
| Zip Code | 60612 |
| Specialty | ORTHOPEDIC SURGERY |
| City + Specialty | CHICAGO + ORTHOPEDIC SURGERY |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.