MARK R GARDNER M.D. NPI 1114055787

NPI Information

  • NPI: 1114055787
  • Provider Name: MARK R GARDNER, M.D.
  • Classification: Preventive Medicine - 2083X0100X
  • Specialization: Occupational Medicine
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 4321 FIR ST STE 313
    EAST CHICAGO, IN
    ZIP 46312
  • Phone: (219) 392-7424

Map and Directions

Get Directions

NPI Details

Mark R Gardner, M.D. is an occupational medicine preventive medicine in East Chicago, IN. The provider is occupational medicine focuses on the health of workers, including the ability to perform work; the physical, chemical, biological, and social environments of the workplace; and the health outcomes of environmental exposures. Practitioners in this field address the promotion of health in the work place, and the prevention and management of occupational and environmental injury, illness, and disability. Mark R Gardner, M.D. NPI is 1114055787. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

4321 FIR ST STE 313
EAST CHICAGO, IN
ZIP 46312-049
Phone: (219) 392-7424
Fax: (219) 392-7450

The NPI 1114055787 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Power Mobility Devices.

The enumeration date for this NPI number is 3/2/2007 and was last updated on 10/13/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207R00000XInternal Medicine01059461AINDIANANo
2207R00000XInternal Medicine036068695ILLINOISNo
32083X0100XPreventive MedicineOccupational Medicine01059461AINDIANAYes
42083X0100XPreventive MedicineOccupational Medicine036068695ILLINOISNo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1769580MEDICARE ID-TYPE UNSPECIFIED
2C41378MEDICARE UPIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

Previous NPI
Next NPI