NPIMap

Organization Active NPI

Chicago Prostate Cancer Surgery Center, LLC

Doing business as Duly Surgery Center Westmont

  • Ambulatory Surgical Clinic/Center
  • Westmont, IL
National Provider Identifier
1497706626
Registry record updated Sep 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
CHICAGO PROSTATE CANCER SURGERY CENTER, LLC
Doing business as
Duly Surgery Center Westmont
Practice address
815 Pasquinelli Dr
Westmont, IL 60559-1276
Phone
(630) 654-2515
Fax
(630) 654-2516
NPI assigned
May 12, 2006
Last updated
Sep 19, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2024

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

Authorized official

Name
Paul Merrick, MDNPI 1679541643
Title
President, Board of Directors
Phone
(630) 790-1221

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X Primary

Addresses

Primary practice location

815 Pasquinelli Dr
Westmont, IL 60559-1276

Mailing address

815 Pasquinelli Dr
Westmont, IL 60559-1276
Phone (630) 654-2515

Other names 1

  • Duly Surgery Center Westmont Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061103000233 IL Part B Supplier - Ambulatory Surgical Center 0547267577 Practice locations: Westmont, IL

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Dupage Medical Group Surgery Center of WestmontCCN 14C0001126
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 23

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.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726704000000",
    "number": "1497706626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 PASQUINELLI DR",
            "city": "WESTMONT",
            "state": "IL",
            "postal_code": "605591276",
            "telephone_number": "630-654-2515",
            "fax_number": "630-654-2516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 PASQUINELLI DR",
            "city": "WESTMONT",
            "state": "IL",
            "postal_code": "605591276",
            "telephone_number": "630-654-2515",
            "fax_number": "630-654-2516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHICAGO PROSTATE CANCER SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-12",
        "last_updated": "2024-09-19",
        "certification_date": "2024-09-19",
        "status": "A",
        "authorized_official_last_name": "MERRICK",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "PRESIDENT, BOARD OF DIRECTORS",
        "authorized_official_telephone_number": "630-790-1221",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Duly Surgery Center Westmont",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Westmont, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2024; 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.