Individual provider Active NPI

Mariam Hussain

  • Surgical Physician Assistant
  • Downers Grove, IL
National Provider Identifier
1669365201
Registry record updated Jun 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
Practice address
2650 Warrenville Rd Ste 280
Downers Grove, IL 60515-2075
Phone
(630) 324-7920
Fax
(630) 271-1813
NPI assigned
Jun 2, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Medical Physician Assistant 363AM0700X
Surgical Physician Assistant 363AS0400X Primary

Addresses

Primary practice location

2650 Warrenville Rd Ste 280
Downers Grove, IL 60515-2075

Mailing address

12205 Red Clover LN
Plainfield, IL 60585-7847
Phone (630) 853-0400

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
I20251125000202 IL Practitioner - Physician Assistant 7214429547 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cardiac Surgery Associates SCGroup PAC ID 2860304102, 44 clinicians

Practice addresses (Care Compare)

133 E Brush Hill Rd
Suite 200
Elmhurst, IL 60126-5661
Phone (630) 782-1500

Hospital & facility affiliations

  • Edward Hospital Hospital, Naperville, IL, CCN 140231

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cardiac Surgery Associates SC CurrentSince Oct 13, 2025 Accepting new patients

Locations

2650 Warrenville Rd
Ste 280
Downers Grove, IL 60515
Phone (630) 324-7920

133 E Brush Hill Rd
Ste 200
Elmhurst, IL 60126

10 Martin Ave
Ste 100
Naperville, IL 60540
Phone (630) 369-7700

3 Erie Ct
Oak Park, IL 60302
Phone (708) 763-6200

Interoperability endpoints

  • Direct secure messaging: mhussain291719@direct.edward.org

Organizations & group practices 1

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1748822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748822400000",
    "number": "1669365201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12205 RED CLOVER LN",
            "city": "PLAINFIELD",
            "state": "IL",
            "postal_code": "605857847",
            "telephone_number": "630-853-0400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2650 WARRENVILLE RD STE 280",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605152075",
            "telephone_number": "630-324-7920",
            "fax_number": "630-271-1813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUSSAIN",
        "first_name": "MARIAM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-02",
        "last_updated": "2025-06-02",
        "certification_date": "2025-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Downers Grove, IL

Sources for this page

Verify at the official NPI Registry.