Individual provider Active NPI

Megan Mary Dusak, P.A.-C

  • Physician Assistant
  • Chicago, IL
National Provider Identifier
1043442544
Registry record updated Jul 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085-003535 Issued in IL
Practice address
131 S Dearborn St Ste 1025
Chicago, IL 60603-5517
Phone
(312) 487-2141
Fax
(312) 577-0767
NPI assigned
Aug 17, 2009
Last updated
Jul 1, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085-003535 IL Primary
Medical Physician Assistant 363AM0700X 085.003535 IL

Addresses

Primary practice location

131 S Dearborn St Ste 1025
Chicago, IL 60603-5517

Mailing address

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

Other practice location 1

350 Park Ave Fl 11
New York, NY 10022-6163
Phone (646) 439-7660

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090903000543 IL Practitioner - Physician Assistant 4284789801 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
085-003535ILMDPhysician Assistant
085.003535ILMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Dupage Medical Group LTD CurrentSince Jan 3, 2022 Accepting new patients
Dupage Medical Group LTD CurrentSince Jan 3, 2022 Accepting new patients
Premise Health of New York Medical PC PastSince Feb 23, 2025 Accepting new patients

Locations

4061 W 95th St
Oak Lawn, IL 60453
Phone (630) 432-6200

1800 N Main St
Wheaton, IL 60187
Phone (630) 469-0045

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1250467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751328000000",
    "number": "1043442544",
    "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": "131 S DEARBORN ST STE 1025",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606035517",
            "telephone_number": "312-487-2141",
            "fax_number": "312-577-0767"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "350 Park Ave Fl 11",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100226163",
            "country_code": "US",
            "telephone_number": "646-439-7660",
            "fax_number": "212-813-3147",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DUSAK",
        "first_name": "MEGAN",
        "middle_name": "MARY",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-17",
        "last_updated": "2025-07-01",
        "certification_date": "2025-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085-003535",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IL",
            "license": "085.003535",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.