NPIMap

Organization Active NPI

Midland Orthopedic Associates PLLC

  • Orthopaedic Surgery Physician
  • Chicago, IL
National Provider Identifier
1104863638
Registry record updated Oct 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
042007805 Issued in IL
Legal business name
MIDLAND ORTHOPEDIC ASSOCIATES PLLC
Practice address
2850 S Wabash Ave
Suite 100
Chicago, IL 60616-2955
Phone
(312) 842-4600
Fax
(312) 842-8694
NPI assigned
Jun 1, 2006
Last updated
Oct 4, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2024

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

Authorized official

Name
Daniel GogginNPI 1336558022
Title
Chief Operating Officer
Phone
(312) 842-4600

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207X00000X 042007805 IL Primary

Addresses

Primary practice location

2850 S Wabash Ave
Suite 100
Chicago, IL 60616-2955

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909

Other names 1

  • Midland Othopedic Associates S C Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041008001051 IL Part B Supplier - Clinic/Group Practice 3971562430 Receives reassigned benefits from 25 practitioners
Practice locations: Tinley Park, IL; Riverside, IL; Oaklawn, IL; La Grange Highlands, IL; La Grange, IL; Hometown, IL; Chicago, IL; Hazel Crest, IL

National Provider Directory

National Provider Directory

Locations

222 W Adams St
Chicago, IL 60606

2850 S Michigan Ave
Ste 200
Chicago, IL 60616

6084 S Archer Ave
Fl 1
Chicago, IL 60638

9717 S Western Ave
Chicago, IL 60643
Phone (708) 448-1207

5201 Willow Springs Rd
Ste 340
La Grange Highlands, IL 60525
Phone (708) 482-7767

353 E Burlington St
Ste 100
Riverside, IL 60546
Phone (708) 324-6641

Practitioners & affiliated clinicians

Practitioners 38

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 38

NPI Registry JSON

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

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728000000000",
    "number": "1104863638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2850 S WABASH AVE",
            "address_2": "SUITE 100",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606162955",
            "telephone_number": "312-842-4600",
            "fax_number": "312-842-8694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDLAND ORTHOPEDIC ASSOCIATES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-01",
        "last_updated": "2024-10-04",
        "certification_date": "2024-10-04",
        "status": "A",
        "authorized_official_last_name": "GOGGIN",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "312-842-4600"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "IL",
            "license": "042007805",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Midland Othopedic Associates S C",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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 Oct 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.