DUPAGE MEDICAL GROUP, LTD. (NPI# 1528206984) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528206984 |
| Entity Type | Organization |
| Organization Name | DUPAGE MEDICAL GROUP, LTD. |
| Practice Address |
430 Pennsylvania Ave 170 Glen Ellyn IL 60137-4464 |
| Mailing Address |
1860 Paysphere Cir Chicago IL 60674-0018 |
| Practice Telephone | 6303228300 |
| Enumeration Date | 2009-01-23 |
| Last Update Date | 2012-09-26 |
| Authorized Official Name | MICHAEL PACETTI (CFO) |
| Authorized Official Telephone | 6304699200 |
| Is Organization Subpart | Y |
| Parent Organization Name | DUPAGE MEDICAL GROUP, LTD. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332H00000X | Eyewear Supplier (Equipment, not the service) | 042-000124 | IL | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | MEDICARE GROUP NUMBER | 785110 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134584816 | Dupage Medical Group, Ltd. | Prosthetic/Orthotic Supplier | 7000 Caton Farm Rd, Suite C, Plainfield, IL 60586-8107 | 2015-12-22 |
| 1497310023 | Dupage Medical Group, Ltd. | Durable Medical Equipment & Medical Supplies | 9618 Southwest Hwy, Oak Lawn, IL 60453-2862 | 2019-05-09 |
| 1811356215 | Dupage Medical Group, Ltd. | Prosthetic/Orthotic Supplier | 2340 S Highland Ave, Lombard, IL 60148-5371 | 2016-02-15 |
| 1295194686 | Dupage Medical Group, Ltd. | Prosthetic/Orthotic Supplier | 40 S Clay St, Hinsdale, IL 60521-3257 | 2016-02-15 |
| 1578920484 | Dupage Medical Group, Ltd. | Prosthetic/Orthotic Supplier | 675 W North Ave, Melrose Park, IL 60160-1634 | 2016-01-22 |
| 1942667852 | Dupage Medical Group, Ltd. | Prosthetic/Orthotic Supplier | 801 N Cass Ave, Westmont, IL 60559-1162 | 2016-01-22 |
| 1538526447 | Dupage Medical Group, Ltd. | Prosthetic/Orthotic Supplier | 199 Town Sq, Wheaton, IL 60189-3801 | 2016-01-22 |
| 1063878965 | Dupage Medical Group, Ltd. | Prosthetic/Orthotic Supplier | 2100 Glenwood Ave, Joliet, IL 60435-5487 | 2016-01-07 |
| 1154787059 | Dupage Medical Group, Ltd. | Prosthetic/Orthotic Supplier | 1240 Essington Rd, Joliet, IL 60435-8408 | 2016-01-07 |
| 1790140531 | Dupage Medical Group, Ltd. | Prosthetic/Orthotic Supplier | 330 Madison St, Suite 103, Joliet, IL 60435-6565 | 2015-12-21 |
| Street Address |
430 PENNSYLVANIA AVE 170 |
| City | GLEN ELLYN |
| State | IL |
| Zip Code | 60137-4464 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649277724 | Arun Kumar Samy | Ophthalmology | 430 Pennsylvania Ave, 170, Glen Ellyn, IL 60137-4464 | 2005-07-05 |
| 1528675014 | Theresa Rose Christopher | Occupational Therapist | 430 Pennsylvania Ave, Glen Ellyn, IL 60137-4464 | 2020-09-28 |
| 1386115350 | Marissa Lynn Walsh | Physician Assistant | 430 Pennsylvania Ave, Glen Ellyn, IL 60137-4464 | 2018-12-16 |
| 1740758317 | Ryan Militzer | Physical Therapist | 430 Pennsylvania Ave, Glen Ellyn, IL 60137-4464 | 2018-11-12 |
| 1881148898 | Marissa Gill | Physical Therapist | 430 Pennsylvania Ave, Ste 210, Glen Ellyn, IL 60137-4464 | 2016-08-08 |
| 1285095455 | Julie Fischer | Physical Therapy Assistant | 430 Pennsylvania Ave, Glen Ellyn, IL 60137-4464 | 2016-03-15 |
| 1659746980 | Silvana Perri | Physician Assistant | 430 Pennsylvania Ave, 350, Glen Ellyn, IL 60137-4464 | 2015-12-12 |
| 1508103136 | Brock A Gorman | Occupational Therapist | 430 Pennsylvania Ave, Glen Ellyn, IL 60137-4464 | 2013-01-16 |
| 1407109739 | Kelli Lynn Madden | Specialist/Technologist, Other | 430 Pennsylvania Ave, Suite 350, Glen Ellyn, IL 60137-4464 | 2012-10-24 |
| 1467701011 | Julie P Kupisch | Physical Therapist | 430 Pennsylvania Ave, Glen Ellyn, IL 60137-4464 | 2012-08-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023619616 | Hetal Patel | Pharmacist | 3 S 100 Rt 53, Glen Ellyn, IL 60137 | 2020-11-02 |
| 1285234930 | Arti Rai | Pharmacist | 3s100 Route 53, Glen Ellyn, IL 60137 | 2020-10-30 |
| 1427658103 | Dimple Zaveri | Pharmacist | 3s 100 Route 53, Glen Ellyn, IL 60137 | 2020-10-30 |
| 1528668373 | Stephanie Caballero Novak | Social Worker | Life Care Wellness, Inc., 800 Roosevelt Rd Building C Suite 206, Glen Ellyn, IL 60137 | 2020-10-30 |
| 1669025367 | Christine Marie Penway | Physical Therapist | 854 Roosevelt Rd Unit E10, Glen Ellyn, IL 60137 | 2019-07-22 |
| 1730652314 | Camille Elizabeth Hawkins | Counselor | 22 W 66 Hackberry, Glen Ellyn, IL 60137 | 2019-01-07 |
| 1710454939 | Jacquelyn Rose Wescott | Student in an Organized Health Care Education/Training Program | 178 Macintosh Ct., Glen Ellyn, IL 60137 | 2018-10-25 |
| 1184133985 | Young Men's Christian Association of Northwestern Du Page County | Health Educator | 49 Deicke Drive, Glen Ellyn, IL 60137 | 2017-09-25 |
| 1447781208 | Neoly Home Care LLC | In Home Supportive Care | N 455 Main Street, Glen Ellyn, IL 60137 | 2017-03-23 |
| 1205283397 | Dianna Christina Ciardullo | Pharmacist | 599 E Roosevelt Road, Glen Ellyn, IL 60137 | 2016-05-18 |
| Find all providers in zip 60137 | ||||
| Taxonomy Code | 332H00000X |
| Grouping | Suppliers |
| Classification | Eyewear Supplier (Equipment, not the service) |
| An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851587216 | Irish Eyes LLC | Eyewear Supplier (Equipment, not the service) | 489 Taft Ave, Suite 100, Glen Ellyn, IL 60137-8209 | 2007-09-19 |
| 1790333789 | Gwa Optical LLC | Eyewear Supplier (Equipment, not the service) | 324 Roosevelt Rd, Glen Ellyn, IL 60137-5647 | 2019-09-03 |
| 1962883694 | Irish Eyes LLC | Eyewear Supplier (Equipment, not the service) | 489 Taft Ave, Suite 100, Glen Ellyn, IL 60137-8209 | 2015-06-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174138168 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 1550 W Lane Rd, Machesney Park, IL 61115-1903 | 2020-09-15 |
| 1588279566 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 1190 S Randall Rd Ste 104, Elgin, IL 60123-4110 | 2020-09-15 |
| 1972129294 | Luxottica Retail North America, Inc | Eyewear Supplier (Equipment, not the service) | 900 W North Ave, Chicago, IL 60642-2506 | 2020-06-23 |
| 1710512801 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 9940 Rt 47, Huntley, IL 60142 | 2020-03-09 |
| 1710512488 | Glasses On Oak St | Eyewear Supplier (Equipment, not the service) | 900 N Michigan Ave Fl 5, Chicago, IL 60611-1542 | 2020-03-03 |
| 1861026890 | Luxottica of America Inc. | Eyewear Supplier (Equipment, not the service) | 5300 Northwest Hwy, Crystal Lake, IL 60014-8072 | 2020-02-28 |
| 1952935181 | Jand. Inc. | Eyewear Supplier (Equipment, not the service) | 4999 Old Orchard Ctr Ste J4, Skokie, IL 60077-1450 | 2020-02-26 |
| 1194355917 | Fr Vision 360, Inc. | Eyewear Supplier (Equipment, not the service) | 111 E Morton Ave, Jacksonville, IL 62650-3059 | 2020-01-21 |
| 1114567443 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 6215 Northwest Hwy, Crystal Lake, IL 60014-7932 | 2020-01-15 |
| 1841833399 | Luxottica of America Inc. | Eyewear Supplier (Equipment, not the service) | Milwaukee Ave & E Towline Rd #e1600, Vernon Hills, IL 60061 | 2019-10-28 |
| Find all providers with the same taxonomy | ||||
| City | GLEN ELLYN |
| Zip Code | 60137 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.