Individual provider Active NPI

Mark E McKeigue, DO

  • Family Medicine Physician
  • Orland Park, IL
National Provider Identifier
1962480657
Registry record updated Feb 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036056879 Issued in IL
Practice address
10755 W 163Rd Place
Orland Park, IL 60467-8861
Phone
(708) 873-1187
Fax
(708) 873-1204
NPI assigned
Jan 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036056879 IL Primary

Addresses

Primary practice location

10755 W 163Rd Place
Orland Park, IL 60467-8861

Mailing address

10755 W 163Rd Place
Orland Park, IL 60467-8861
Phone (708) 873-1187

Other identifiers 1

IdentifierTypeStateIssuer
036056879MedicaidIL

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
I20040319000777 IL Practitioner - Family PracticePractitioner - Osteopathic Manipulative Medicine 1850281056 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Osteopathic Manipulative Medicine
Education
Chicago College of Osteopathy, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Health Service Systems, IncGroup PAC ID 2264408699, 63 clinicians

Practice addresses (Care Compare)

1890 Silver Cross Blvd
Suite 265
New Lenox, IL 60451-9623
Phone (815) 727-4292

Hospital & facility affiliations

  • Silver Cross Hospital and Medical Centers Hospital, New Lenox, IL, CCN 140213

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036056879ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Susan Rife Family Medicine SC Family Medicine CurrentSince Nov 17, 2003 Accepting new patients
Health Service Systems, Inc Family Medicine CurrentSince Jun 3, 2024 Accepting new patients
Health Service Systems, Inc CurrentSince Jun 3, 2024 Accepting new patients
Osteopathic Sports Medicine, S.C. Past Accepting new patients

Locations

1900 Silver Cross Blvd
New Lenox, IL 60451
Phone (815) 300-7106

1890 Silver Cross Blvd
Ste 265
New Lenox, IL 60451
Phone (815) 727-4292

10755 163rd Pl
Orland Park, IL 60467
Phone (708) 873-1187

Organizations & group practices 4

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 2

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": "1136332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391472000000",
    "number": "1962480657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10755 W 163RD PLACE",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604678861",
            "telephone_number": "708-873-1187",
            "fax_number": "708-873-1204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10755 W 163RD PLACE",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604678861",
            "telephone_number": "708-873-1187",
            "fax_number": "708-873-1204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKEIGUE",
        "first_name": "MARK",
        "middle_name": "E",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-04",
        "last_updated": "2014-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036056879",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036056879",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orland Park, IL

Sources for this page

Verify at the official NPI Registry.