NPIMap

Organization Active NPI

Dupage Medical Group LTD

  • Physical Therapy Clinic/Center
  • Lombard, IL
National Provider Identifier
1316347347
Registry record updated Oct 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
070020798 Issued in IL
Legal business name
DUPAGE MEDICAL GROUP LTD
Practice address
1801 S Highland Ave
Suite L10
Lombard, IL 60148-4932
Phone
(630) 967-2000
Fax
(630) 261-6901
NPI assigned
Aug 27, 2014
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, MD
Title
Chairman of the Board
Phone
(630) 790-1221

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X 070020798 IL Primary
Durable Medical Equipment & Medical Supplies 332B00000X 042000124 IL
Prosthetic/Orthotic Supplier 335E00000X 042000124 IL

Addresses

Primary practice location

1801 S Highland Ave
Suite L10
Lombard, IL 60148-4932

Mailing address

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

Other identifiers 2

IdentifierTypeStateIssuer
205994OtherILMEDICARE GROUP PTAN
785110OtherILMEDICARE GROUP PTAN

Other names 1

  • Dupage Medical Group Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Glen Ellyn Clinic SC la35 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 19

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1409097600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697068800000",
    "number": "1316347347",
    "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": "1801 S HIGHLAND AVE",
            "address_2": "SUITE L10",
            "city": "LOMBARD",
            "state": "IL",
            "postal_code": "601484932",
            "telephone_number": "630-967-2000",
            "fax_number": "630-261-6901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DUPAGE MEDICAL GROUP LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-27",
        "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": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "IL",
            "license": "070020798",
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "IL",
            "license": "042000124",
            "primary": false
        },
        {
            "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": "Dupage Medical Group",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Dupage Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lombard, 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.

Verify at the official NPI Registry.