NPIMap

Organization Active NPI

Dupage Medical Group, LTD.

Doing business as DuPage Medical Group

  • Durable Medical Equipment & Medical Supplies
  • Joliet, IL
National Provider Identifier
1063878965
Registry record updated Oct 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
DUPAGE MEDICAL GROUP, LTD.
Doing business as
DuPage Medical Group
Practice address
2100 Glenwood Ave
Joliet, IL 60435-5487
Phone
(815) 725-2121
NPI assigned
Jan 7, 2016
Last updated
Oct 12, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Paul Merrick, MDNPI 1679541643
Title
Chairman of the Board
Phone
(630) 790-1221

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X IL Primary

Addresses

Primary practice location

2100 Glenwood Ave
Joliet, IL 60435-5487

Mailing address

PO Box 713260
Chicago, IL 60677-1260
Phone (630) 469-9200

Other names 1

  • DuPage Medical Group Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031110000348 IL Part B Supplier - Clinic/Group Practice 5496667941 Receives reassigned benefits from 176 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
O20160301000986 IL DME Supplier - Multi-Specialty - Physician 5496667941 Practice locations: Joliet, IL

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Glen Ellyn Allergy Dept35 organizations share this tax ID, including this one

Other organizations with this tax ID 34

Organizations that report the same tax identification number in the National Provider Directory.

View all 34

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1452124800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697068800000",
    "number": "1063878965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 713260",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606771260",
            "telephone_number": "630-469-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 GLENWOOD AVE",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604355487",
            "telephone_number": "815-725-2121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DUPAGE MEDICAL GROUP, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-07",
        "last_updated": "2023-10-12",
        "certification_date": "2023-10-12",
        "status": "A",
        "authorized_official_last_name": "MERRICK",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "CHAIRMAN OF THE BOARD",
        "authorized_official_telephone_number": "630-790-1221",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DuPage Medical Group",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "DuPage Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Joliet, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.