Individual provider Active NPI

Dorothy T Prusek, M.D.

  • Internal Medicine Physician
  • Elmhurst, IL
National Provider Identifier
1871592378
Registry record updated Feb 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036081546 Issued in IL
Practice address
755 N York St
Elmhurst, IL 60126-1607
Phone
(331) 221-2900
Fax
(331) 221-2733
NPI assigned
Jul 18, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036081546 IL Primary

Addresses

Primary practice location

755 N York St
Elmhurst, IL 60126-1607

Mailing address

755 N York St
Elmhurst, IL 60126-1607
Phone (331) 221-2900

Other identifiers 2

IdentifierTypeStateIssuer
036081546MedicaidIL
02232472OtherILBLUE CROSS/BLUE SHIELD #

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dprusek45360@direct.edward.org Direct

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
I20040527000247 IL Practitioner - Internal Medicine 0345221115 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Endeavor Health Medical GroupGroup PAC ID 2163334699, 3,330 clinicians

Practice addresses (Care Compare)

2650 Ridge Ave
Evanston, IL 60201-1700

755 N York St
Elmhurst, IL 60126-1607
Phone (331) 221-2900

Hospital & facility affiliations

  • Residential Home Health Home health agency, Lisle, IL, CCN 147568
  • Elmhurst Memorial Hospital Hospital, Elmhurst, IL, CCN 140200
  • Edward Hospital Hospital, Naperville, IL, CCN 140231
  • Loyola University Medical Center Hospital, Maywood, IL, CCN 140276

Merit-based Incentive Payment System (MIPS)

Final score
84.9 of 100Reported as group
Quality
75.91
Promoting interoperability
99
Improvement activities
40
Cost
74.6

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group Internal Medicine Current Accepting new patients
Edward Health Ventures CurrentSince Jan 1, 2022 Accepting new patients
Edward Health Ventures Internal Medicine CurrentSince Jan 1, 2022 Accepting new patients
Endeavor Health Medical Group CurrentSince Nov 30, 2023 Accepting new patients

Locations

9532 Eagle Way
Chicago, IL 60678

429 N York St
Elmhurst, IL 60126
Phone (331) 221-4350

363 N York St
Elmhurst, IL 60126
Phone (630) 279-8200

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

2650 Ridge Ave
Ste 1223
Evanston, IL 60201
Phone (847) 982-3175

2650 Ridge Ave
#1223
Evanston, IL 60201
Phone (847) 982-3172

3033 Ogden Ave
Ste 101
Lisle, IL 60532
Phone (630) 646-6200

120 Spalding Dr
Ste 310
Naperville, IL 60540
Phone (630) 527-5575

120 Spalding Dr
Ste 101
Naperville, IL 60540
Phone (630) 527-7730

6701 US Highway 34
Oswego, IL 60543
Phone (630) 646-4200

24600 W 127th St
Ste B100
Plainfield, IL 60585
Phone (815) 731-9000

Interoperability endpoints

  • Direct secure messaging: dprusek45360@direct.edward.org

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 and National Provider Directory roles.

Hospital & facility affiliations 5

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": "1121644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612742400000",
    "number": "1871592378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "755 N YORK ST",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601261607",
            "telephone_number": "331-221-2900",
            "fax_number": "331-221-2733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 N YORK ST",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601261607",
            "telephone_number": "331-221-2900",
            "fax_number": "331-221-2733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRUSEK",
        "first_name": "DOROTHY",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-18",
        "last_updated": "2021-02-08",
        "certification_date": "2021-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036081546",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036081546",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD #",
            "identifier": "02232472",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dprusek45360@direct.edward.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "755 N York St",
            "city": "Elmhurst",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601261607",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Elmhurst, IL

Sources for this page

Verify at the official NPI Registry.