Organization
DUPAGE MEDICAL GROUP LTD
Active
Other names
Dupage Medical Group
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
1801 S HIGHLAND AVE, SUITE L10, LOMBARD, IL 60148-4932
(630) 967-2000
(630) 261-6901
Mailing address
PO BOX 713260, CHICAGO, IL 60677-1260
(630) 469-9200
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
070020798
IL
332B00000X
Durable Medical Equipment & Medical Supplies
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
08/27/2014
Last updated
10/12/2023
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