Individual provider Active NPI

George S Miz, MD

  • Orthopaedic Surgery Physician
  • Flossmoor, IL
National Provider Identifier
1770570699
Registry record updated Feb 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
036062367 Issued in IL
Practice address
19550 Governors Hwy Ste 1400
Flossmoor, IL 60422-2136
Phone
(708) 647-7565
Fax
(708) 225-7671
NPI assigned
Oct 5, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 036062367 IL Primary

Addresses

Primary practice location

19550 Governors Hwy Ste 1400
Flossmoor, IL 60422-2136

Mailing address

27702 Network PL
Chicago, IL 60673-1277
Phone (708) 862-7674

Other identifiers 2

IdentifierTypeStateIssuer
036-062367MedicaidIL
F400384564OtherILMEDICARE

Medicare participation

Medicare enrollment files
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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071009000368 IL Practitioner - Orthopedic Surgery 3577658335

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1551 Huntington Dr
Calumet City, IL 60409-5440

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Ucm Medical Group Sub, LLC Orthopaedic Surgery CurrentSince Jun 1, 2017 Accepting new patients

Locations

150 Harvester Dr
Ste 300
Burr Ridge, IL 60527
Phone (773) 702-1061

1600 Torrence Ave
Calumet City, IL 60409
Phone (708) 730-1300

1600 167th St
Ste 900
Calumet City, IL 60409
Phone (708) 647-7565

27702 Network Pl
Chicago, IL 60673

19550 Governors Hwy
Ste 1400
Flossmoor, IL 60422
Phone (708) 647-7565

1 Ingalls Dr
Harvey, IL 60426
Phone (708) 333-2300

Interoperability endpoints

  • Direct secure messaging: gmiz179469@uchospital.direct-ci.com

Organizations & group practices 1

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 1

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

NPI Registry JSON

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

{
    "created_epoch": "1128470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550188800000",
    "number": "1770570699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27702 NETWORK PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606731277",
            "telephone_number": "708-862-7674",
            "fax_number": "708-862-1781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19550 GOVERNORS HWY STE 1400",
            "city": "FLOSSMOOR",
            "state": "IL",
            "postal_code": "604222136",
            "telephone_number": "708-647-7565",
            "fax_number": "708-225-7671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIZ",
        "first_name": "GEORGE",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-05",
        "last_updated": "2019-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "IL",
            "license": "036062367",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036-062367",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "F400384564",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Flossmoor, IL

Sources for this page

Verify at the official NPI Registry.