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Organization
DUPAGE MEDICAL GROUP, LTD
Active
Organization
DUPAGE MEDICAL GROUP, LTD
Active
Other names
High Street Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL MERRICK MD (CHAIRMAN OF THE BOARD)
(630) 790-1221
Entity
Organization
Contact information
Practice address
2320 HIGH STREET, BLUE ISLAND, IL 60406
(708) 388-0033
(708) 388-0257
Mailing address
430 WARRENVILLE ROAD, SUITE # 215, LISLE, IL 60532
(708) 388-0033
(708) 388-0257
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
0054005063
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001671073
BC BS OF IL
IL
05
—
362757948001
—
IL
Enumeration date
11/28/2006
Last updated
10/13/2023
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