Organization
DU PAGE MEDICAL GROUP, LTD
Active
Parent organization
DU PAGE MEDICAL GROUP, LTD
Organization subpart
Yes
Provider details
NPI number
Legal business name
DU PAGE MEDICAL GROUP, LTD
Authorized official
PAUL MERRICK MD (CHAIRMAN OF THE BOARD)
(630) 790-1221
Entity
Organization
Contact information
Practice address
12004 RT. 59, PLAINFIELD, IL 60585
(630) 510-6929
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
—
569810
MEDICARE GROUP NUMBERS
IL
01
—
785110
MEDICARE GROUP NUMBER
IL
Enumeration date
04/26/2011
Last updated
10/12/2023
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