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General NPI Number Information
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NPI Number | 1780868562
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Entity Type | Organization
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Legal Business Name | DU PAGE MEDICAL GROUP, LTD
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Dates
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Enumeration Date | 12/28/2007
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Last Update Date | 12/19/2025
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Provider Practice Location Address
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Address Line | 17495 LA GRANGE RD
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City | TINLEY PARK
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State | IL
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Zip | 60487-7581
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Country | US
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Telephone | 708-226-7000
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Fax |
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Provider Business Mailing Address
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Address Line | 17495 LA GRANGE RD
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City | TINLEY PARK
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State | IL
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Zip | 60487-7581
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Country | US
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Telephone | 708-226-7000
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Fax | 708-226-7174
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Authorized Official
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Title or Position | CHAIRMAN OF THE BOARD
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Name | PAUL MERRICK
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Credential | MD
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Telephone | 630-790-1221
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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