Specialty Orthopaedics LLC

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

036118586 Issued in NU

Legal business name

SPECIALTY ORTHOPAEDICS LLC

Practice address

911 N Elm St Ste 327
Hinsdale, IL 60521-3642

Phone

(630) 387-6589

Fax

(630) 387-9789

NPI assigned

Jan 29, 2018

Last updated

Oct 12, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Samuel Park, MDNPI 1851504377

Title

Physician/President

Phone

(630) 743-1337

Specialties & licenses 1

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 1

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.

• Samuel Sanghong Park, MD

  • Orthopaedic Surgery Physician
  • Hinsdale, IL
  • NPI 1851504377
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1517184000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665532800000",
    "number": "1235637851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "911 N ELM ST STE 327",
            "city": "HINSDALE",
            "state": "IL",
            "postal_code": "605213642",
            "telephone_number": "630-387-6589",
            "fax_number": "630-387-9789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "911 N ELM ST STE 327",
            "city": "HINSDALE",
            "state": "IL",
            "postal_code": "605213642",
            "telephone_number": "630-387-6589",
            "fax_number": "630-387-9789"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20000 Governors Dr Ste 101",
            "address_purpose": "LOCATION",
            "city": "Olympia Fields",
            "state": "IL",
            "postal_code": "604613001",
            "country_code": "US",
            "telephone_number": "630-387-6589",
            "fax_number": "630-387-9789",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12 Salt Creek Ln Ste 350",
            "address_purpose": "LOCATION",
            "city": "Hinsdale",
            "state": "IL",
            "postal_code": "605218612",
            "country_code": "US",
            "telephone_number": "630-387-6589",
            "fax_number": "630-387-9789",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SPECIALTY ORTHOPAEDICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-29",
        "last_updated": "2022-10-12",
        "certification_date": "2022-10-12",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_title_or_position": "PHYSICIAN/PRESIDENT",
        "authorized_official_telephone_number": "630-743-1337",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NU",
            "license": "036118586",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "office@sporthopaedic.com",
            "affiliation": "N",
            "endpointDescription": "Office",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Office",
            "address_1": "20000 Governors Dr Ste 101",
            "city": "Olympia Fields",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604613001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicfhir.aurora.org/fhir/myaurora/api/fhir/dstu2",
            "affiliation": "N",
            "endpointDescription": "Office",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Office",
            "address_1": "20000 Governors Dr Ste 101",
            "city": "Olympia Fields",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604613001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Orthopaedic Surgery Physician in Hinsdale, IL
• Providers in Hinsdale, IL by specialty
• Orthopaedic Surgery Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2022; 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.