NPIMap

Organization Active NPI

Dupage Pediatrics

  • Health Maintenance Organization
  • Darien, IL
National Provider Identifier
1437136256
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Maintenance OrganizationTaxonomy code 302R00000X
Legal business name
DUPAGE PEDIATRICS
Practice address
1306 Plainfield Rd
Darien, IL 60561-5038
Phone
(630) 810-0900
Fax
(630) 810-1037
NPI assigned
Dec 22, 2005
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Dr. Garry Gardner, M.D.
Title
Executive Officer
Phone
(630) 810-0900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Maintenance Organization 302R00000X IL Primary

Addresses

Primary practice location

1306 Plainfield Rd
Darien, IL 60561-5038

Mailing address

1306 Plainfield Rd
Darien, IL 60561-5038
Phone (630) 810-0900

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
14D0422157Dupage Pediatrics1306 Plainfield Rd, Darien, IL 60561Certificate of waiverMar 30, 2027

National Provider Directory

National Provider Directory

Locations

1306 Plainfield Rd
Darien, IL 60561
Phone (630) 810-0900

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1135209600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1437136256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1306 PLAINFIELD RD",
            "city": "DARIEN",
            "state": "IL",
            "postal_code": "605615038",
            "telephone_number": "630-810-0900",
            "fax_number": "630-810-1037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1306 PLAINFIELD RD",
            "city": "DARIEN",
            "state": "IL",
            "postal_code": "605615038",
            "telephone_number": "630-810-0900",
            "fax_number": "630-810-1037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DUPAGE PEDIATRICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-22",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "GARDNER",
        "authorized_official_first_name": "GARRY",
        "authorized_official_title_or_position": "EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "630-810-0900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Darien, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.