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

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

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 Hospital · Winfield, IL · CCN 140242
  • Northwestern Medicine McHenry Hospital · McHenry, IL · CCN 140116
  • Northwestern Medicine Delnor Community Hospital Hospital · Geneva, IL · CCN 140211

Merit-based Incentive Payment System (MIPS)

Final score
95.63 of 100 (apm)
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 IDStateProvider typePAC IDDetails
I20050414001188 IL Practitioner - Internal Medicine 0648217257

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036093807ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Dupage Physician Group Internal Medicine Current
since Oct 22, 2014
Accepting new patients
Central Dupage Physician Group Current
since Oct 22, 2014
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)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
920540OtherILMEDICARE PTAN (GROUP)
036093807MedicaidIL
F400172697OtherILMEDICARE PTAN (INDIVIDUAL)

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Apr 1, 2015.

{
    "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

All providers in Carol Stream, IL · Internal Medicine Physician in Illinois

Sources for this page

Verify at the official NPI Registry.