Active NPI
Du Page Medical Group LTD
- Durable Medical Equipment & Medical Supplies
- Naperville, IL
National Provider Identifier
1275878134
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Durable Medical Equipment & Medical Supplies
- License
- 042000124
- Legal business name
- DU PAGE MEDICAL GROUP LTD
- Doing business as
- Du Page Medical Group
- Practice address
- 1948 Three Farms Ave
Naperville, IL 60540-1105 - Phone
- (630) 547-8000
- NPI assigned
- Dec 4, 2012
- Organization subpart
- Yes
- Parent organization
- DU PAGE MEDICAL GROUP LTD
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Paul Merrick, MD
- Title
- Chairman of the Board
- Phone
- (630) 790-1221
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | 042000124 | IL | Primary |
| Prosthetic/Orthotic Supplier | 335E00000X | 042000124 | IL |
Addresses
Primary practice location
1948 Three Farms Ave
Naperville, IL 60540-1105
Mailing address
PO Box 713260
Chicago, IL 60677-1260
Phone (630) 469-9200
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 205994 | Other | IL | MEDICARE GROUP PTAN |
| 785110 | Other | IL | MEDICARE GROUP PTAN |
Other names 1
- Du Page Medical Group
National Provider Directory
National Provider Directory- Part of
- Glen Ellyn Clinic SC la
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1354579200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1697068800000",
"number": "1275878134",
"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": "1948 THREE FARMS AVE",
"city": "NAPERVILLE",
"state": "IL",
"postal_code": "605401105",
"telephone_number": "630-547-8000"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DU PAGE MEDICAL GROUP LTD",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "DU PAGE MEDICAL GROUP LTD",
"enumeration_date": "2012-12-04",
"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
},
{
"code": "335E00000X",
"taxonomy_group": "",
"desc": "Prosthetic/Orthotic Supplier",
"state": "IL",
"license": "042000124",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE GROUP PTAN",
"identifier": "205994",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE GROUP PTAN",
"identifier": "785110",
"state": "IL"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Du Page Medical Group",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Du Page Medical Group",
"code": "3",
"type": "Doing Business As"
}
]
}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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.