Individual provider Active NPI

Calvin M Mar, MD

  • Obstetrics & Gynecology Physician
  • Orland Park, IL
National Provider Identifier
1972514925
Registry record updated Aug 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
036067226 Issued in IL
Practice address
10735 W 159TH Street
Orland Park, IL 60467
Phone
(708) 873-7775
Fax
(708) 873-0192
NPI assigned
Aug 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 036067226 IL Primary

Addresses

Primary practice location

10735 W 159TH Street
Orland Park, IL 60467

Mailing address

PO Box 713260
Chicago, IL 60677-1260
Phone (630) 469-9200

Other identifiers 1

IdentifierTypeStateIssuer
036067226MedicaidIL

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address cmar171159@direct.edward.org
Direct Messaging Address cmar171159@dulyhealthandcare.direct-ci.com

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
I20111010000532 IL Practitioner - Obstetrics/Gynecology 5991974016 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Dupage Medical Group LTD CurrentSince Jul 17, 2017 Accepting new patients
Dupage Medical Group LTD CurrentSince Jul 17, 2017 Accepting new patients

Locations

30 Stratford Dr
Bloomingdale, IL 60108
Phone (630) 893-2210

1860 Paysphere Cir
Chicago, IL 60674
Phone (630) 469-2000

10735 W 159th St
Orland Park, IL 60467
Phone (708) 873-7775

Interoperability endpoints

  • Direct secure messaging: cmar171159@direct.edward.org

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691625600000",
    "number": "1972514925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 713260",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606771260",
            "telephone_number": "630-469-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10735 W 159TH STREET",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "60467",
            "telephone_number": "708-873-7775",
            "fax_number": "708-873-0192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAR",
        "first_name": "CALVIN",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-11",
        "last_updated": "2023-08-10",
        "certification_date": "2023-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "036067226",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036067226",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cmar171159@direct.edward.org",
            "affiliation": "N",
            "address_1": "10735 W 159th Street",
            "city": "Orland Park",
            "state": "IL",
            "country_code": "US",
            "postal_code": "60467",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cmar171159@dulyhealthandcare.direct-ci.com",
            "affiliation": "N",
            "address_1": "10735 W 159th Street",
            "city": "Orland Park",
            "state": "IL",
            "country_code": "US",
            "postal_code": "60467",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Orland Park, IL

Sources for this page

Verify at the official NPI Registry.