Mark Richard Bednard, DO
Individual provider Active NPI Internal Medicine Physician · Carol Stream, IL
NPI 1346212503 · NPPES record last updated Apr 1, 2015
Key facts
- NPI
- 1346212503
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 036093807 (IL)
- Practice address
- 501 Thornhill Dr
Carol Stream, IL 60188-2793 - Phone
- (630) 668-3210
- NPI assigned
- Feb 2, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 6
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Internal Medicine
- Education
- Chicago Homeopathic Medical College, 1993
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
25 N Winfield Rd
Winfield, IL 60190-1295
501 Thornhill Dr
Carol Stream, IL 60188-2793
680 N Lake Shire Dr
Suite 1000
Chicago, IL 60611-8709
909 Hidden Ridge Rd
Suite 300
Irving, TX 75038-3801
Hospital & facility affiliations
- Northwestern Medicine Central Dupage Hospital
- Northwestern Medicine McHenry
- Northwestern Medicine Delnor Community Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 95.63 of 100
- Quality
- 88.47
- Promoting interoperability
- 100
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050414001188 | IL | Practitioner - Internal Medicine | 0648217257 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036093807 | IL | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Central Dupage Physician Group | Internal Medicine | Current |
Accepting new patients |
| Central Dupage Physician Group | Current |
Accepting new patients | |
| Central Dupage Hospital Association | Past | Accepting new patients | |
| Holy Cross Hospital | Internal Medicine | Past | Accepting new patients |
| Gibson Community Hospital Association | Past | Accepting new patients | |
| Pahcs II | Past | Accepting new patients |
Locations
501 Thornhill Dr
Carol Stream, IL 60188
Phone (630) 653-1918
Dept 5777
Carol Stream, IL 60122
Carol Stream, IL 60122
Phone (630) 933-3300
1800 N Main St
Wheaton, IL 60187
Phone (630) 469-0045
25 N Winfield Rd
Winfield, IL 60190
Phone (630) 682-1600
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 036093807 | IL | Yes |
Addresses
Primary practice location
501 Thornhill Dr
Carol Stream, IL 60188-2793
Mailing address
501 Thornhill Dr
Carol Stream, IL 60188-2793
Phone (630) 668-3210
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 920540 | Other | IL | MEDICARE PTAN (GROUP) |
| 036093807 | Medicaid | IL | |
| F400172697 | Other | IL | MEDICARE PTAN (INDIVIDUAL) |
NPI Registry JSON
{
"created_epoch": "1138838400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1427846400000",
"number": "1346212503",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "501 THORNHILL DR",
"city": "CAROL STREAM",
"state": "IL",
"postal_code": "601882793",
"telephone_number": "630-668-3210"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "501 THORNHILL DR",
"city": "CAROL STREAM",
"state": "IL",
"postal_code": "601882793",
"telephone_number": "630-668-3210"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BEDNARD",
"first_name": "MARK",
"middle_name": "RICHARD",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-02",
"last_updated": "2015-04-01",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "IL",
"license": "036093807",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN (GROUP)",
"identifier": "920540",
"state": "IL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036093807",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN (INDIVIDUAL)",
"identifier": "F400172697",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Carol Stream, IL
- Thea Isabel Barba
- Sharon Bartsch
- William Bayer
- BDD of Illinois P.C.
- Patrick F Bednar
- Jennifer A. Bejaoui
- John Joseph Berkemeyer
- Courtney Berry Ewasiuk
- Stacey Bextel
- David J Blackman
All providers in Carol Stream, IL · Internal Medicine Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 1, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.