Mark Edward Runge, DDS, MS

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

019017664 Issued in IL

Practice address

518 Hillgrove Avenue
Suite 100
Western Springs, IL 60558-1480

Phone

(708) 246-8881

Fax

(708) 246-6858

NPI assigned

Mar 5, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

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.

• The Board of Trustees of the University of Illinois

  • Anatomic Pathology Physician
  • Chicago, IL
  • NPI 1386863819
  Medicare reassignment NPD
• Board of Trustees Fo the University of Illinois

  • Oral and Maxillofacial Surgery (Dentist)
  • Chicago, IL
  • NPI 1326483991
  NPD
• The Board of Trustees of the University of Illinois

  • Occupational Medicine Physician
  • Chicago, IL
  • NPI 1043727571
  NPD
• The Board of Trustees of the University of Illinois

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1134118649
  NPD (past)

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616716800000",
    "number": "1679602312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "518 HILLGROVE AVENUE",
            "address_2": "SUITE 100",
            "city": "WESTERN SPRINGS",
            "state": "IL",
            "postal_code": "605581480",
            "telephone_number": "708-246-8881",
            "fax_number": "708-246-6858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "518 HILLGROVE AVENUE",
            "address_2": "SUITE 100",
            "city": "WESTERN SPRINGS",
            "state": "IL",
            "postal_code": "605581480",
            "telephone_number": "708-246-8881",
            "fax_number": "708-246-6858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUNGE",
        "first_name": "MARK",
        "middle_name": "EDWARD",
        "credential": "DDS, MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-05",
        "last_updated": "2021-03-26",
        "certification_date": "2021-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "IL",
            "license": "021001388",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "IL",
            "license": "019017664",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Roundys Supermarkets Inc
• Renee G Rowley, PT, PCS
• Brian L Rozanski, D.P.M.
• Jay Ruban, DPT
• Renee Rubinelli
• Nathan D Rusk, DPT
• Jeri Susan Russell-Aiello, R.N.
• Patricia Elizabeth Sagols, PHARM.D.
• Laura C. Sanchez, B.S. PSYCHOLOGY
• Marvin Sanders

• Orthodontics and Dentofacial Orthopedics Dentistry in Western Springs, IL
• Providers in Western Springs, IL by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.