Individual provider Active NPI

Richard A Sodetz, MD

  • Orthopaedic Surgery Physician
  • Chicago, IL
National Provider Identifier
1063682466
Registry record updated Mar 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Practice address
641 S Ashland Ave
Unit J
Chicago, IL 60607-3167
Phone
(715) 865-5002
NPI assigned
Mar 3, 2008
Last updated
Mar 3, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 3, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X IL Primary

Addresses

Primary practice location

641 S Ashland Ave
Unit J
Chicago, IL 60607-3167

Mailing address

N5329 Dugan Lake Road
PO Box 297
Stone Lake, WI 54876-0297
Phone (715) 865-5002

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036-043448ILMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Orthopedic Consultants SC Orthopaedic Surgery Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1204502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204502400000",
    "number": "1063682466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N5329 DUGAN LAKE ROAD",
            "address_2": "PO BOX 297",
            "city": "STONE LAKE",
            "state": "WI",
            "postal_code": "548760297",
            "telephone_number": "715-865-5002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "641 S ASHLAND AVE",
            "address_2": "UNIT J",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606073167",
            "telephone_number": "715-865-5002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SODETZ",
        "first_name": "RICHARD",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-03-03",
        "last_updated": "2008-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.