Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dane Jack Church, MD

Individual provider Adult Reconstructive Orthopaedic Surgery Physician · NPI 1790128387

Dane Jack Church, MD is an Orthopedic Surgery in Springfield, Illinois. Qualified in 2013, 13 years ago. Practices with Orthopaedic Center of Il, a 30-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
13
Licensed in
IL
In the registry since
2013
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1301 S Koke Mill Rd
Springfield, IL 62711-9252
Phone: (217) 547-9100
Fax: (217) 547-9236
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 2301 Holmes St, Kansas City, MO 64108-2640 — (816) 404-4175

Specialties & licences

Adult Reconstructive Orthopaedic Surgery Physician (primary) Taxonomy 207XS0114X · Licence 036148467 (IL)

Record details

NPI number1790128387
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedApril 12, 2013
Last updated in NPPESApril 13, 2020
Certification dateApril 13, 2020
Mailing address1301 S Koke Mill Rd, Springfield, IL 62711-9252

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyORTHOPEDIC SURGERY
Medical schoolOTHER
Graduated 2013 (13 years in practice)
Group practice Orthopaedic Center Of Il — 30 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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