Dupage Medical Group, LTD

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

License

042-000124 Issued in IL

Legal business name

DUPAGE MEDICAL GROUP, LTD

Practice address

1327 Butterfield Rd
618
Downers Grove, IL 60515-1078

Phone

(630) 322-8300

NPI assigned

Jan 23, 2009

Organization subpart

Yes

Parent organization

DUPAGE MEDICAL GROUP, LTD.As reported in NPPES

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

Authorized official

Name

Paul Merrick, MD

Title

Chairman of the Board

Phone

(630) 790-1221

Specialties & licenses 1

Addresses

Other identifiers 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Part of

Glen Ellyn Clinic SC la

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

{
    "created_epoch": "1232668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697155200000",
    "number": "1891933255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 713260",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606771260",
            "telephone_number": "630-469-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1327 BUTTERFIELD RD",
            "address_2": "618",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605151078",
            "telephone_number": "630-322-8300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DUPAGE MEDICAL GROUP, LTD",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DUPAGE MEDICAL GROUP, LTD.",
        "enumeration_date": "2009-01-23",
        "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": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "IL",
            "license": "042-000124",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "785110",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Joshua Duplessis, DC, ATC
• Trinidad Parungao Duran, RN
• Jo Duren-Sampson, LCSW
• Demi A Durham

• All providers in Downers Grove, IL
• Eyewear Supplier 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.
• 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.