Healthcare Provider Details

I. General information

NPI: 1255323481
Provider Name (Legal Business Name): DUPAGE EMERGENCY PHYSICIANS LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/15/2005
Last Update Date: 01/19/2021
Certification Date: 01/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3815 HIGHLAND AVE
DOWNERS GROVE IL
60515-1500
US

IV. Provider business mailing address

PO BOX 95279
CHICAGO IL
60694-5279
US

V. Phone/Fax

Practice location:
  • Phone: 630-275-5900
  • Fax: 630-734-1560
Mailing address:
  • Phone: 877-485-4474
  • Fax: 405-341-9217

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MARC SPILLER
Title or Position: PRESIDENT
Credential: MD
Phone: 888-447-2450