Healthcare Provider Details

I. General information

NPI: 1114262326
Provider Name (Legal Business Name): DUPAGE IMMEDIATE CARE, LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/29/2012
Last Update Date: 01/13/2025
Certification Date: 01/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1S210 SUMMIT AVE
OAKBROOK TERRACE IL
60181-3933
US

IV. Provider business mailing address

1S210 SUMMIT AVE
OAKBROOK TERRACE IL
60181
US

V. Phone/Fax

Practice location:
  • Phone: 630-282-6002
  • Fax: 630-282-7322
Mailing address:
  • Phone: 630-282-6002
  • Fax: 630-282-7322

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number68548217
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. IBRAHIM A MAJZOUB
Title or Position: CEO / PRESIDENT
Credential: M.D.
Phone: 630-282-6002