NPIMap

Organization Active NPI

Dupage Medical Group, LTD.

  • Durable Medical Equipment & Medical Supplies
  • Naperville, IL
National Provider Identifier
1093953465
Registry record updated Oct 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
042000124 Issued in IL
Legal business name
DUPAGE MEDICAL GROUP, LTD.
Practice address
808 Rickert Dr
102
Naperville, IL 60540-0905
Phone
(630) 364-7400
NPI assigned
Jan 23, 2009
Last updated
Oct 12, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
DUPAGE MEDICAL GROUP, LTD.As reported in NPPES

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 042000124 IL Primary

Addresses

Primary practice location

808 Rickert Dr
102
Naperville, IL 60540-0905

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
785110OtherILMEDICARE GROUP NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

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

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
Part of
Glen Ellyn Allergy Dept

Locations

808 Rickert Dr
Ste 102
Naperville, IL 60540
Phone (630) 364-7400

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": "1232668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697068800000",
    "number": "1093953465",
    "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": "808 RICKERT DR",
            "address_2": "102",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605400905",
            "telephone_number": "630-364-7400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DUPAGE MEDICAL GROUP, LTD.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DUPAGE MEDICAL GROUP, LTD.",
        "enumeration_date": "2009-01-23",
        "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": "042000124",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "785110",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Naperville, 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.