Dupage Medical Group, LTD

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

DUPAGE MEDICAL GROUP, LTD

Doing business as

Dupage Medical Group, Ltd

Practice address

2320 High St
Blue Island, IL 60406-2426

Phone

(708) 388-5500

Fax

(708) 388-5672

NPI assigned

May 18, 2006

Last updated

Oct 13, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Paul Merrick, MDNPI 1679541643

Title

Chairman of the Board

Phone

(630) 790-1221

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Dupage Medical Group, Ltd Doing business as

Locations

Practitioners 2

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.

• Paul Merrick, MD

  • Urology Physician
  • Lisle, IL
  • NPI 1679541643
  Authorized official Same address or phone
• Daniel A Frankel, M.D.

  • Diagnostic Radiology Physician
  • Palos Heights, IL
  • NPI 1497747497
  NPD (past)

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697155200000",
    "number": "1700839230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2320 HIGH ST",
            "address_2": "ADMINISTRATION",
            "city": "BLUE ISLAND",
            "state": "IL",
            "postal_code": "604062426",
            "telephone_number": "708-388-5500",
            "fax_number": "708-226-7170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2320 HIGH ST",
            "city": "BLUE ISLAND",
            "state": "IL",
            "postal_code": "604062426",
            "telephone_number": "708-388-5500",
            "fax_number": "708-388-5672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DUPAGE MEDICAL GROUP, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-18",
        "last_updated": "2023-10-13",
        "certification_date": "2023-10-13",
        "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": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CD5640",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LOCALITY15 MEDICARE",
            "identifier": "IL3596",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER ID",
            "identifier": "01621031",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dupage Medical Group, Ltd",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Dupage Medical Group, Ltd",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Multi-Specialty Clinic/Center in Blue Island, IL
• Providers in Blue Island, IL by specialty
• Multi-Specialty Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 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.