Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Edward John Supan, PA-C

Individual provider Physician Assistant · NPI 1477013407

Edward John Supan, PA-C is a Physician Assistant in Chicago, Illinois. Qualified in 2018, 8 years ago. Practices with Northwestern Medical Faculty Foundation, a 4,394-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Illinois.

Years since qualifying
8
Licensed in
IL
In the registry since
2019
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

635 N Dearborn St
Chicago, IL 60654-4618
Phone: (312) 694-2273
Fax: (312) 694-2129
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 085007043 (IL)

Record details

NPI number1477013407
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedMarch 25, 2019
Last updated in NPPESMay 1, 2019

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice Northwestern Medical Faculty Foundation — 4394 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations15 on file with Medicare

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