Physician Compare National (NPI:1821448663)

HEALTHCARE PROVIDER: KEVIN MICHAEL CHANG M.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1821448663
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	2567753379
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20190627000183
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	CHANG
	Individual professional last name
Provider First Name	KEVIN
	Individual professional first name
Provider Middle Name	MICHAEL
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	WAYNE STATE UNIVERSITY SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	2016
	Individual professional's medical school graduation year
Primary Specialty	EMERGENCY MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	AURORA EMERGENCY PHYSICIANS LLC
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	1850657180
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	34
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	2000 OGDEN AVE
	Group Practice or individual's line 1 address
City	AURORA
	Group Practice or individual's city
State	IL
	Group Practice or individual's state
Zip Code	605047222
	Group Practice or individual's zip code (9 digits when available)
Phone Number	6304668200
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	140029
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	COPLEY MEMORIAL HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y