Organization
DUPAGE MEDICAL GROUP, LTD
Active
Parent organization
DUPAGE MEDICAL GROUP, LTD
Other names
DuPage Medical Group
Organization subpart
Yes
Provider details
NPI number
Legal business name
DUPAGE MEDICAL GROUP, LTD
Authorized official
MR. PAUL MERRICK (CHAIRMAN OF THE BOARD)
(630) 790-1221
Entity
Organization
Contact information
Practice address
651 S ROUTE 59, AURORA, IL 60504-8169
(630) 967-2000
(630) 547-8001
Mailing address
PO BOX 713260, CHICAGO, IL 60677-1260
(630) 469-9200
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
042000124
IL
335E00000X
Prosthetic/Orthotic Supplier
042000124
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
205994
MEDICARE GROUP PTAN
IL
01
—
785110
MEDICARE GROUP PTAN
IL
Enumeration date
05/20/2015
Last updated
10/12/2023
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