MEDICARE: DR. DUSAN STEFOSKI MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084N0400X	Neurology Physician	036051797	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	CS336016711	OTHER	IL	IL DEPT OF PROG REGUL
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1376521724
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DUSAN STEFOSKI MD

Provider Business Mailing Address
First Line	:	1725 W HARRISON
Second Line	:	#309 UNIVERSITY NEUROLOGISTS MS CENTER
City	:	CHICAGO
State	:	IL
Zip	:	60612-3824
Country	:	US
Telephone Number	:	312-942-8011
Fax Number	:	312-563-4009

Provider Business Practice Location Address
First Line	:	1725 W HARRISON
Second Line	:	#309 UNIVERSITY NEUROLOGISTS MS CENTER
City	:	CHICAGO
State	:	IL
Zip	:	60612-3824
Country	:	US
Telephone Number	:	312-942-8011
Fax Number	:	312-563-4009

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/05/2006
Last Update Date	:	03/07/2023

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