MARK FLETCHER BORDICK (NPI# 1699728725) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699728725 |
| Entity Type | Individual |
| Full Name | MARK FLETCHER BORDICK |
| Credential | PA-C |
| Practice Address |
10719 West 160th Street Orland Park IL 60467 |
| Practice Telephone | 7082263300 |
| Practice Fax Number | 7082264202 |
| Mailing Telephone | 7082263300 |
| Mailing Fax Number | 7082264202 |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
IL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
10719 WEST 160TH STREET |
| City | ORLAND PARK |
| State | IL |
| Zip Code | 60467 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407809528 | Michael John Meeker | Physician Assistant | 10719 West 160th Street, Orland Park, IL 60467-5541 | 2006-05-18 |
| 1457373953 | Midwest Orthopedic Consultants Sc | Orthopaedic Surgery | 10719 West 160th Street, Orland Park, IL 60467-5541 | 2006-07-24 |
| 1083661086 | George Branovacki | Orthopaedic Surgery | 10719 West 160th Street, Orland Park, IL 60467-5541 | 2006-05-27 |
| 1134174352 | Richard Dennis Lim | Orthopaedic Surgery | 10719 West 160th Street, Orland Park, IL 60467-5541 | 2006-05-24 |
| 1811940034 | Jeremy Thomas Bell | Physician Assistant | 10719 West 160th Street, Orland Park, IL 60467-5541 | 2006-05-18 |
| 1407809635 | Sung-lana Kim | Physical Medicine & Rehabilitation | 10719 West 160th Street, Orland Park, IL 60467 | 2006-05-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700435666 | Abigail Flaherty | Specialist/Technologist | 17430 Brookwood Ct, Orland Park, IL 60467 | 2019-09-04 |
| 1114483567 | Allison Winkelman I | Behavioral Analyst | 8505 West 183rd Street, Ste D, Tinley Park, ID 60467 | 2019-02-11 |
| 1043794332 | Stella Lewally | Nurse Practitioner | 11528 183rd St, Orland Park, IL 60467 | 2018-09-21 |
| 1992202535 | Du Page Medical Group Ltd | Durable Medical Equipment & Medical Supplies | 16660 South 107th Avenue, Orland Park, IL 60467 | 2018-04-10 |
| 1467955781 | Dr Matthew E Schmidt & Associates Ophthalmologists S.c. | Eyewear Supplier (Equipment, not the service) | 10732 W 165th St, Orland Park, IL 60467 | 2018-03-13 |
| 1053835694 | Mbr In-home Care, LLC | In Home Supportive Care | 16616 S 107th Court, Orland Park, IL 60467 | 2017-07-26 |
| 1568984029 | Meaghan Hansen Hansen | Nurse Practitioner | Laser Spine Center of Chicago, 16604 S. 107th Ct., Orland Park, IL 60467 | 2017-07-16 |
| 1790212587 | Maria Degrazia Cohen | Developmental Therapist | 9800 Liberty Circle, 3w, Orland Park, IL 60467 | 2017-05-11 |
| 1902354319 | Debra Kramer | Nurse Practitioner | 14315 South 108th Ave., Suite 215, Orland Park, IL 60467 | 2016-09-14 |
| 1689071524 | Morgan Johnson | Specialist/Technologist | 11141 Saratoga Drive, Orland Park, IL 60467 | 2014-11-20 |
| Find all providers in zip 60467 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407809528 | Michael John Meeker | Physician Assistant | 10719 West 160th Street, Orland Park, IL 60467-5541 | 2006-05-18 |
| 1255709721 | Nick Patel | Physician Assistant | 10719 160th St, Orland Park, IL 60467-5541 | 2015-09-14 |
| 1811940034 | Jeremy Thomas Bell | Physician Assistant | 10719 West 160th Street, Orland Park, IL 60467-5541 | 2006-05-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477169522 | Priority Assist Pllc | Physician Assistant | 48 Glenda Ln, Plano, IL 60545-9652 | 2020-09-23 |
| 1154944478 | Diana Goldak | Physician Assistant | 3855 N Parkway Dr Apt 3a, Northbrook, IL 60062-7218 | 2020-05-20 |
| 1033742580 | Colleen Courtney | Physician Assistant | 218 S Driftwood Trl, Mchenry, IL 60050-5454 | 2020-02-12 |
| 1326678962 | Nina Kodros | Physician Assistant | 301 Madison St Ste 280, Joliet, IL 60435-6672 | 2020-01-23 |
| 1689218190 | Jennifer Richman | Physician Assistant | 1890 Silver Cross Blvd Ste 410, New Lenox, IL 60451-9547 | 2019-10-29 |
| 1710547625 | Nadia Khan | Physician Assistant | 4543 N Malden St Apt 1s, Chicago, IL 60640-5687 | 2019-06-13 |
| 1962065516 | Jorge Mantilla | Physician Assistant | 5540 N Kimball Ave Apt 3e, Chicago, IL 60625-4674 | 2019-04-18 |
| 1013479955 | Leah Rae Prager | Physician Assistant | 4400 W. 95th St., Attn: Pediatric General Surgery, Oak Lawn, IL 60453 | 2019-04-01 |
| 1770041949 | Laura Ann Ryan | Physician Assistant | 840 S Wood St Ste 417, Chicago, IL 60612-4325 | 2019-03-06 |
| 1548739782 | Helen Finke | Physician Assistant | 880 W Central Rd Ste 3300, Arlington Heights, IL 60005-2366 | 2018-11-16 |
| Find all providers with the same taxonomy | ||||
| City | ORLAND PARK |
| Zip Code | 60467 |
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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.