NPIMap

Organization Active NPI

Central Dupage Health

  • Non-Pharmacy Dispensing Site
  • Glen Ellyn, IL
National Provider Identifier
1356644595
Registry record updated Jan 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
Legal business name
CENTRAL DUPAGE HEALTH
Practice address
885 Roosevelt Rd
Suite 101
Glen Ellyn, IL 60137-6168
Phone
(630) 384-6200
NPI assigned
Dec 9, 2010
Last updated
Jan 25, 2016By the provider in NPPES
Organization subpart
Yes
Parent organization
CENTRAL DUPAGE HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 25, 2016

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

Authorized official

Name
Maura McKay, DO
Title
Medical Director
Phone
(952) 653-2568

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Pharmacy Dispensing Site 332900000X NU Primary

Addresses

Primary practice location

885 Roosevelt Rd
Suite 101
Glen Ellyn, IL 60137-6168

Mailing address

6501 City West Pkwy
Eden Prairie, MN 55344-3248
Phone (952) 653-2568

Other names 1

  • NW Medicine Convenient Care Other name

National Provider Directory

National Provider Directory
Tax ID family
Central Dupage Hosp Ect12 organizations share this tax ID, including this one
Part of
Central Dupage Hosp Ect

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

Locations

885 Roosevelt Rd
Ste 101
Glen Ellyn, IL 60137
Phone (630) 315-6151

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1291852800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1453680000000",
    "number": "1356644595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6501 CITY WEST PKWY",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553443248",
            "telephone_number": "952-653-2568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "885 ROOSEVELT RD",
            "address_2": "SUITE 101",
            "city": "GLEN ELLYN",
            "state": "IL",
            "postal_code": "601376168",
            "telephone_number": "630-384-6200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL DUPAGE HEALTH",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CENTRAL DUPAGE HEALTH",
        "enumeration_date": "2010-12-09",
        "last_updated": "2016-01-25",
        "status": "A",
        "authorized_official_last_name": "MCKAY",
        "authorized_official_first_name": "MAURA",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "952-653-2568",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NW Medicine Convenient Care",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Glen Ellyn, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2016; 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.