Active NPI
Agnieszka Dus
- Registered Nurse
- Dekalb, IL
National Provider Identifier
1902275753
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 041.429086
- Practice address
- 12 Health Services Dr
Dekalb, IL 60115-9637 - Phone
- (815) 756-4875
- NPI assigned
- Sep 23, 2015
- Last updated
- Sep 23, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 041.429086 | IL | Primary |
Addresses
Primary practice location
12 Health Services Dr
Dekalb, IL 60115-9637
Mailing address
12 Health Services Dr
Dekalb, IL 60115-9637
Phone (815) 756-4875
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 362771343001 | Medicaid | IL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 041.429086 | IL | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dekalb Behavioral Health Foundation, Inc. | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Northwestern Medicine Ben Gordon Center
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Dekalb, IL
- NPI 1255703450
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1442966400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1442966400000",
"number": "1902275753",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12 HEALTH SERVICES DR",
"city": "DEKALB",
"state": "IL",
"postal_code": "601159637",
"telephone_number": "815-756-4875"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12 HEALTH SERVICES DR",
"city": "DEKALB",
"state": "IL",
"postal_code": "601159637",
"telephone_number": "815-756-4875"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUS",
"first_name": "AGNIESZKA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-09-23",
"last_updated": "2015-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "IL",
"license": "041.429086",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "362771343001",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Dekalb, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.