Dongwoo John Chang, M.D.

Primary specialty

Neurological Surgery PhysicianTaxonomy code 207T00000X

License

036120333 Issued in IL

Practice address

305 W Jackson St Ste 400
Carbondale, IL 62901-1474

Phone

(618) 351-4972

Fax

(618) 351-4973

NPI assigned

Nov 22, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Dongwoo John Chang Professional name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL, MI, NY3 enrollments

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 3

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Southern Illinois Medical Services, NFP

  • Internal Medicine Physician
  • Carbondale, IL
  • NPI 1770656837
  Medicare reassignment NPD
• St. Peter'S Hospital of the City of Albany

  • General Acute Care Hospital
  • Albany, NY
  • NPI 1518042357
  Medicare reassignment NPD
• W. a. Foote Memorial Hospital, Inc

  • Internal Medicine Physician
  • Jackson, MI
  • NPI 1760437826
  Medicare reassignment NPD
• Portercare Adventist Health System

  • Physical Medicine & Rehabilitation Physician
  • Denver, CO
  • NPI 1164834008
  NPD
• Portercare Adventist Health System

  • Otolaryngology Physician
  • Greenwood Village, CO
  • NPI 1760761928
  NPD
• Portercare Adventist Health System

  • Urology Physician
  • Lakewood, CO
  • NPI 1942165626
  NPD
• St. Peter'S Hospital of the City of Albany

  • General Acute Care Hospital
  • Albany, NY
  • NPI 1497701106
  NPD
• W.a. Foote Memorial Hospital, Inc

  • Physician Assistant
  • Jackson, MI
  • NPI 1538606348
  NPD
• Wa Foote Memorial Hospital, Inc

  • Internal Medicine Physician
  • Jackson, MI
  • NPI 1831123728
  NPD
• Lehigh Valley Physician Group

  • Transplant Surgery Physician
  • Allentown, PA
  • NPI 1457309650

  Neurological Surgery

  NPD (past)
• Osu Surgery, LLC

  • Surgery Physician
  • Columbus, OH
  • NPI 1538117551
  NPD (past)

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

{
    "created_epoch": "1132617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646870400000",
    "number": "1962485037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3988",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629023988",
            "telephone_number": "618-351-4972",
            "fax_number": "618-351-4973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 W JACKSON ST STE 400",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629011474",
            "telephone_number": "618-351-4972",
            "fax_number": "618-351-4973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANG",
        "first_name": "DONGWOO",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-22",
        "last_updated": "2022-03-10",
        "certification_date": "2022-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "IL",
            "license": "036120333",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dchang25751@sih.direct-ci.com",
            "affiliation": "N",
            "address_1": "305 W Jackson St Ste 400",
            "city": "Carbondale",
            "state": "IL",
            "country_code": "US",
            "postal_code": "629011474",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "DONGWOO",
            "last_name": "CHANG",
            "middle_name": "JOHN",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Stephanie Marie Chambers-Baltz, PHD, LP
• Jenifer Marie Chambless, PA-C
• Kyle Michael Chamness, PTA
• Laura E Chandler, MS/CCC-SLP
• Rakesh Chandra, MD
• Hark Chang, M.D.
• Radhika Chang, MD
• Chapman Language and Literacy, PLLC
• Hadasah Chapman, MA, CCC-SLP
• Saul Howard Chapman, PH.D.

• Neurological Surgery Physician in Carbondale, IL
• Providers in Carbondale, IL by specialty
• Neurological Surgery Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2022; 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.