Individual provider Active NPI

Dusan Stefoski, MD

  • Neurology Physician
  • Chicago, IL
National Provider Identifier
1376521724
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
036051797 Issued in IL
Practice address
1725 W Harrison
#309 University Neurologists Ms Center
Chicago, IL 60612-3824
Phone
(312) 942-8011
Fax
(312) 563-4009
NPI assigned
Jan 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 036051797 IL Primary

Addresses

Primary practice location

1725 W Harrison
#309 University Neurologists Ms Center
Chicago, IL 60612-3824

Mailing address

1725 W Harrison
#309 University Neurologists Ms Center
Chicago, IL 60612-3824
Phone (312) 942-8011

Other identifiers 2

IdentifierTypeStateIssuer
CS336016711OtherILIL DEPT OF PROG REGUL
036051797MedicaidIL

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040310001393 IL Practitioner - Neurology 6800785726 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036051797ILMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rush University Medical Center Neurology CurrentSince Nov 1, 2020 Accepting new patients
Rush University Medical Group Neurology CurrentSince Nov 1, 2020 Accepting new patients
Gibson Community Hospital Association Past Accepting new patients

Locations

75 Remittance Dr
Dept 1611
Chicago, IL 60675

1725 W Harrison St
Ste 1118
Chicago, IL 60612
Phone (312) 942-5936

1725 W Harrison St
Ste 1106
Chicago, IL 60612
Phone (312) 563-2144

1700 W Van Buren St
#500
Chicago, IL 60612
Phone (312) 563-2875

1725 W Harrison St
Ste 309
Chicago, IL 60612
Phone (312) 942-8011

Interoperability endpoints

  • Direct secure messaging: dstefoski4073@direct.rush.rush-health.com

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1136419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1376521724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1725 W HARRISON",
            "address_2": "#309 UNIVERSITY NEUROLOGISTS MS CENTER",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123824",
            "telephone_number": "312-942-8011",
            "fax_number": "312-563-4009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1725 W HARRISON",
            "address_2": "#309 UNIVERSITY NEUROLOGISTS MS CENTER",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123824",
            "telephone_number": "312-942-8011",
            "fax_number": "312-563-4009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEFOSKI",
        "first_name": "DUSAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-05",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "IL",
            "license": "036051797",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IL DEPT OF PROG REGUL",
            "identifier": "CS336016711",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036051797",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.