Active NPI
Mark J Holterman, M.D.
- Pediatric Surgery Physician
- Chicago, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Surgery Physician
- Practice address
- 1725 W Harrison St
Suite 818
Chicago, IL 60612-3841 - Phone
- (312) 942-5397
- NPI assigned
- May 6, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Surgery Physician | 2086S0120X | IL | Primary |
Addresses
Primary practice location
1725 W Harrison St
Suite 818
Chicago, IL 60612-3841
Mailing address
1725 W Harrison St
Suite 818
Chicago, IL 60612-3841
Phone (312) 942-5397
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- General Surgery
- Education
- University of Virginia School of Medicine, 1988
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1 S210 Summit Ave
Oak Brook, IL 60181-3933
Phone (630) 282-6002
Hospital & facility affiliations
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of tissue | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-095619 | IL | MD | Pediatric Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dupage Immediate Care, LTD | Current | Accepting new patients | |
| Mount Sinai Community Foundation | Current | Accepting new patients | |
| Mount Sinai Community Foundation | Current | Accepting new patients | |
| Mount Sinai Community Foundation | Current | Accepting new patients | |
| Gibson Community Hospital Association | Past | Accepting new patients | |
| Loyola University Physician Foundation | Past | Accepting new patients |
Locations
26460 Network Pl
Chicago, IL 60673
Phone (708) 786-2900
1S210 Summit Ave
Oakbrook Terrace, IL 60181
Phone (630) 282-6002
Organizations & group practices 6
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Urgent Care Clinic/Center
- Oakbrook Terrace, IL
- NPI 1114262326
-
dba Sinai Medical Group
- Rehabilitation Hospital
- Chicago, IL
- NPI 1376715896
-
dba SMG Antillas Family Medical Center
- Family Medicine Physician
- Chicago, IL
- NPI 1144383084
-
dba Sinai Medical Group
- General Acute Care Hospital
- Chicago, IL
- NPI 1982657854
-
dba Gibson Area Hospital and Health Services
- Critical Access Hospital
- Gibson City, IL
- NPI 1114935681
-
- General Practice Physician
- Maywood, IL
- NPI 1235148891
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Northwestern Medicine Central Dupage Hospital
- General Acute Care Hospital
- Winfield, IL
- NPI 1003864810
-
dba Northwestern Medicine Central Dupage Hospital
- Psychiatric Hospital Unit
- Winfield, IL
- NPI 1740230895
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146873600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1033168273",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1725 W HARRISON ST",
"address_2": "SUITE 818",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606123841",
"telephone_number": "312-942-5397"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1725 W HARRISON ST",
"address_2": "SUITE 818",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606123841",
"telephone_number": "312-942-5397"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLTERMAN",
"first_name": "MARK",
"middle_name": "J",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-06",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2086S0120X",
"taxonomy_group": "",
"desc": "Surgery, Pediatric Surgery",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.