NPIMap

Organization Active NPI

Du Page Medical Group LTD

Doing business as LaGrange Road Pharmacy

  • Pharmacy
  • Tinley Park, IL
National Provider Identifier
1154481588
Registry record updated Mar 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
054019950 Issued in IL
Legal business name
DU PAGE MEDICAL GROUP LTD
Doing business as
LaGrange Road Pharmacy
Practice address
17495 La Grange Rd
Tinley Park, IL 60487-7581
Phone
(708) 226-7100
Fax
(708) 226-7178
NPI assigned
Dec 8, 2006
Last updated
Mar 20, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2017

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

Authorized official

Name
Nitika Agarwal
Title
Director of Pharmacy
Phone
(630) 432-6371

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X 054019950 IL Primary
Community/Retail Pharmacy 3336C0003X NU

Addresses

Primary practice location

17495 La Grange Rd
Tinley Park, IL 60487-7581

Mailing address

17495 La Grange Rd
Tinley Park, IL 60487-7581
Phone (708) 226-7100

Other identifiers 1

IdentifierTypeStateIssuer
2162402OtherPK

Other names 1

  • LaGrange Road Pharmacy Doing business as

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

NPI Registry JSON

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

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489968000000",
    "number": "1154481588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17495 LA GRANGE RD",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604877581",
            "telephone_number": "708-226-7100",
            "fax_number": "708-226-7178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17495 LA GRANGE RD",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604877581",
            "telephone_number": "708-226-7100",
            "fax_number": "708-226-7178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DU PAGE MEDICAL GROUP LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-08",
        "last_updated": "2017-03-20",
        "status": "A",
        "authorized_official_last_name": "AGARWAL",
        "authorized_official_first_name": "NITIKA",
        "authorized_official_title_or_position": "DIRECTOR OF PHARMACY",
        "authorized_official_telephone_number": "630-432-6371"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "IL",
            "license": "054019950",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2162402",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LaGrange Road Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tinley Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.