NPIMap

Organization Active NPI

Dupage Medical Group, LTD.

  • Durable Medical Equipment & Medical Supplies
  • Naperville, IL
National Provider Identifier
1295970713
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
100 Spalding Dr
3Rd Floor
Naperville, IL 60540-6550
Phone
(630) 355-8000
NPI assigned
Dec 12, 2008
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, MD
Title
Chairman of the Board
Phone
(630) 790-1221

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 042000124 IL Primary

Addresses

Primary practice location

100 Spalding Dr
3Rd Floor
Naperville, IL 60540-6550

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
O20100930072616 IL DME Supplier - Physician - General Practice 5496667941 Practice locations: Naperville, IL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
14D2111615Dupage Medical Group - Cardiology100 Spalding Dr, Ste 400, Naperville, IL 60540Certificate of waiverApr 10, 2028

National Provider Directory

National Provider Directory
Tax ID family
Glen Ellyn Clinic SC la35 organizations share this tax ID, including this one
Part of
Glen Ellyn Clinic SC la

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": "1229040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697068800000",
    "number": "1295970713",
    "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": "100 SPALDING DR",
            "address_2": "3RD FLOOR",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605406550",
            "telephone_number": "630-355-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DUPAGE MEDICAL GROUP, LTD.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DUPAGE MEDICAL GROUP, LTD.",
        "enumeration_date": "2008-12-12",
        "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.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.