Individual
MARK K CHANG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
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
207X00000X
Orthopaedic Surgery Physician
Primary
036095817
IL
207X00000X
Orthopaedic Surgery Physician
200033540A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036095817
—
IL
05
—
200868870A
—
IN
01
—
P00419910
RAILROAD MEDICARE
—
Enumeration date
08/19/2006
Last updated
02/05/2025
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