Organization
DU PAGE MEDICAL GROUP LTD
Active
Other names
Du Page 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
25 N WINFIELD RD, STE 405, WINFIELD, IL 60190
(630) 790-1221
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
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
569810
MEDICARE GROUP PTAN
IL
01
—
785110
MEDICARE GROUP PTAN
IL
Enumeration date
09/28/2011
Last updated
10/13/2023
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