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Organization

MARK K CHANG MD

Active
Other names
Midwest SpineCare, SC
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MARK K. CHANG MD (MEDICAL DIRECTOR)
(219) 836-4955
Entity
Organization

Contact information

Practice address
1100 JOLIET ST, STE 104, DYER, IN 46311-1996
(219) 836-4955
(219) 865-2377
Mailing address
1100 JOLIET ST, STE 104, DYER, IN 46311-1996
(219) 836-4955
(219) 865-2377

Taxonomy

Speciality
Code
Description
License number
State
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
036095817
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200868870A
IN
01
DG1633
RR MEDICARE
IL
Enumeration date
05/15/2007
Last updated
01/13/2015
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