Individual provider Active NPI

Margaret Isely Dauphin-Van Dyk, M.D.

  • Specialist
  • Chicago, IL
National Provider Identifier
1801852926
Registry record updated Aug 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
036059705 Issued in IL
Practice address
2800 N Sheridan Rd Ste 406
Chicago, IL 60657-6158
Phone
(312) 201-0044
Fax
(773) 697-4628
NPI assigned
Apr 26, 2006
Last updated
Aug 31, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 31, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 036059705 IL Primary

Addresses

Primary practice location

2800 N Sheridan Rd Ste 406
Chicago, IL 60657-6158

Mailing address

2738 Lincoln Street
Evanston, IL 60201-2043
Phone (847) 869-7159

Other identifiers 1

IdentifierTypeStateIssuer
036059705MedicaidIL

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL vandyksoffice1212@gmail.com Health Information Exchange (HIE)

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
I20040927001011 IL Practitioner - Internal Medicine 8325017320 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2800 N Sheridan Rd
Suite 406
Chicago, IL 60657-6158
Phone (312) 201-0044

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Margaret I. Dauphin-Van Dyk M.D., S.C. CurrentSince Jan 1, 2005 Accepting new patients
Presence Healthcare Services Past Accepting new patients

Locations

111 N Wabash Ave
Ste 1212
Chicago, IL 60602
Phone (312) 201-0044

2800 N Sheridan Rd
Ste 406
Chicago, IL 60657
Phone (312) 201-0044

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/23339/brand/1/csg/1/fhir/r4
  • Direct secure messaging: margaret.dauphin.van.dyk.1@23339.direct.athenahealth.com

Organizations & group practices 2

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.

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": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661904000000",
    "number": "1801852926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2738 LINCOLN STREET",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602012043",
            "telephone_number": "847-869-7159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 N SHERIDAN RD STE 406",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606576158",
            "telephone_number": "312-201-0044",
            "fax_number": "773-697-4628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAUPHIN-VAN DYK",
        "first_name": "MARGARET",
        "middle_name": "ISELY",
        "name_prefix": "Mrs.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-04-26",
        "last_updated": "2022-08-31",
        "certification_date": "2022-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "IL",
            "license": "036059705",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036059705",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "vandyksoffice1212@gmail.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2800 N Sheridan Rd Ste 406",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606576158",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.