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

Mark Ambrose, PA-C

Individual provider Physician Assistant · NPI 1043424740

Mark Ambrose, PA-C is a Physician Assistant in Hazel Crest, Illinois. Licensed in Illinois. Registered with an NPI since 2007.

Licensed in
IL
In the registry since
2007
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

See every abbreviation used in this directory →

Practice location Address checks out

3330 W 177th St Ste 3E
Hazel Crest, IL 60429-2184
Phone: (708) 206-0010
Fax: (708) 206-0020
Show map & directions

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

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 085000830 (IL)

Record details

NPI number1043424740
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedMay 10, 2007
Last updated in NPPESMay 13, 2016
Mailing address16450 104th Ave, Ste 101, Orland Park, IL 60467-5416

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