Organization
DUPAGE MEDICAL GROUP, LTD
Active
Organization
DUPAGE MEDICAL GROUP, LTD
Active
Other names
Dupage Medical Group, Ltd
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 ST, BLUE ISLAND, IL 60406-2426
(708) 388-5500
(708) 388-5672
Mailing address
2320 HIGH ST, ADMINISTRATION, BLUE ISLAND, IL 60406-2426
(708) 388-5500
(708) 226-7170
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01621031
BCBS PROVIDER ID
IL
01
—
CD5640
RAILROAD MEDICARE
IL
01
—
IL3596
LOCALITY15 MEDICARE
IL
Enumeration date
05/18/2006
Last updated
10/13/2023
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