Individual provider Active NPI

Edyta Teresa Dudek

  • Family Nurse Practitioner
  • Elk Grove Village, IL
National Provider Identifier
1841757747
Registry record updated Feb 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209018629 Issued in IL
Practice address
800 Biesterfield Rd
Elk Grove Village, IL 60007-3361
Phone
(847) 981-3694
NPI assigned
Feb 27, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209018629 IL Primary

Addresses

Primary practice location

800 Biesterfield Rd
Elk Grove Village, IL 60007-3361

Mailing address

800 Biesterfield Rd
Elk Grove Village, IL 60007-3361
Phone (847) 981-3694

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
I20190521001930 IL Practitioner - Nurse Practitioner 2668715368 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Metro Infectious Disease Consultants LLCGroup PAC ID 3072425784, 386 clinicians

Practice addresses (Care Compare)

901 McClintock Dr
Suite 202
Burr Ridge, IL 60527-0872
Phone (888) 220-6432

Hospital & facility affiliations

  • Advocate Lutheran General Hospital Hospital, Park Ridge, IL, CCN 140223
  • Amita Health Resurrection Medical Center Hospital, Chicago, IL, CCN 140117

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209018629ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Metro Infectious Disease Consultants LLC CurrentSince Jul 1, 2021 Accepting new patients
Metro Infectious Disease Consultants, LLC CurrentSince Jul 1, 2021 Accepting new patients

Locations

400 Remington Blvd
Bolingbrook, IL 60440
Phone (630) 226-8100

901 McClintock Dr
Ste 202
Burr Ridge, IL 60527
Phone (630) 654-4201

901 McClintock Dr
Ste 104
Burr Ridge, IL 60527
Phone (630) 986-4580

310 W Plaza Dr
Carterville, IL 62918
Phone (618) 525-0719

1435 N Randall Rd
Ste 404
Elgin, IL 60123
Phone (847) 741-5091

800 Biesterfield Rd
Ste 4011
Elk Grove Vlg, IL 60007
Phone (847) 981-3694

1300 Franklin Ave
Ste 230C
Normal, IL 61761
Phone (309) 585-6029

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1551225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551225600000",
    "number": "1841757747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 BIESTERFIELD RD",
            "city": "ELK GROVE VILLAGE",
            "state": "IL",
            "postal_code": "600073361",
            "telephone_number": "847-981-3694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 BIESTERFIELD RD",
            "city": "ELK GROVE VILLAGE",
            "state": "IL",
            "postal_code": "600073361",
            "telephone_number": "847-981-3694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUDEK",
        "first_name": "EDYTA",
        "middle_name": "TERESA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-27",
        "last_updated": "2019-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209018629",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elk Grove Village, IL

Sources for this page

Verify at the official NPI Registry.