Dupage Medical Group LTD.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

054014358 Issued in IL

Legal business name

DUPAGE MEDICAL GROUP LTD.

Practice address

2614 W. Jefferson St.
Joliet, IL 60435

Phone

(815) 730-3030

Fax

(815) 725-9450

NPI assigned

Sep 30, 2006

Organization subpart

No

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

Authorized official

Name

Melissa Detella, PHARMD

Title

Pharmacy Manager

Phone

(708) 226-7100

Specialties & licenses 5

Addresses

Other names 1

• JOHA Pharmacy Doing business as

Tax ID family

Joliet Oncology Hematology Assoc LTD2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Joliet Oncology-Hematology Associates LTD

  • Durable Medical Equipment & Medical Supplies
  • Joliet, IL
  • NPI 1568943637
  NPD tax ID

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

{
    "created_epoch": "1159574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675728000000",
    "number": "1801989249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2614 W. JEFFERSON ST.",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "60435",
            "telephone_number": "815-730-3030",
            "fax_number": "815-725-9450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2614 W. JEFFERSON ST.",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "60435",
            "telephone_number": "815-730-3030",
            "fax_number": "815-725-9450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DUPAGE MEDICAL GROUP LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-30",
        "last_updated": "2023-02-07",
        "certification_date": "2023-02-07",
        "status": "A",
        "authorized_official_last_name": "DETELLA",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "PHARMACY MANAGER",
        "authorized_official_telephone_number": "708-226-7100",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IL",
            "license": "054014358",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "JOHA Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Meaghan Dugan
• Dulce,Martinez and Pinto Family Medical Centers, S.C.
• Christine Lin Dunham, D.D.S.
• Nicole K Dunn, MA, CCC-SLP
• Dupage Medical Group LTD
• Dupage Medical Group, LTD.
• Dupage Medical Group, LTD.
• Dupage Medical Group, LTD.
• Lizette Anahi Duran
• Sarah E Durkin, M.E.

• Community/Retail Pharmacy in Joliet, IL
• Providers in Joliet, IL by specialty
• Community/Retail Pharmacy in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 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.