CENTRAL DUPAGE PHYSICIAN GROUP (NPI# 1033149844) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033149844 |
| Entity Type | Organization |
| Organization Name | CENTRAL DUPAGE PHYSICIAN GROUP |
| Other Organization Name | NORTHWESTERN MEDICINE REGIONAL MEDICAL GROUP |
| Practice Address |
5777 Department Carol Stream IL 60122-5777 |
| Practice Telephone | 6309333300 |
| Practice Fax Number | 6309332740 |
| Mailing Telephone | 6309333300 |
| Mailing Fax Number | 6309332740 |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2018-08-17 |
| Authorized Official Name | PATRICK TOWNE (PREIDENT) |
| Authorized Official Telephone | 6309331600 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207QG0300X |
Family Medicine Specialization: Geriatric Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207RE0101X |
Internal Medicine Specialization: Endocrinology, Diabetes & Metabolism |
Allopathic & Osteopathic Physicians | ||
| N | 207RG0300X |
Internal Medicine Specialization: Geriatric Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 207RR0500X |
Internal Medicine Specialization: Rheumatology |
Allopathic & Osteopathic Physicians | ||
| N | 207T00000X | Neurological Surgery | Allopathic & Osteopathic Physicians | ||
| N | 207VX0201X |
Obstetrics & Gynecology Specialization: Gynecologic Oncology |
Allopathic & Osteopathic Physicians | ||
| N | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians | ||
| N | 2083S0010X |
Preventive Medicine Specialization: Sports Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 2085N0700X |
Radiology Specialization: Neuroradiology |
Allopathic & Osteopathic Physicians | ||
| N | 2085R0204X |
Radiology Specialization: Vascular & Interventional Radiology |
Allopathic & Osteopathic Physicians | ||
| N | 208M00000X | Hospitalist | Allopathic & Osteopathic Physicians | ||
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | MEDICARE RAILROAD MWB | 080116892 | 01 |
| ID | BLUE CROSS GROUP NUMBER | 0222075 | 01 |
| Other Name | Type Code |
|---|---|
| Northwestern Medicine Regional Medical Group | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972847317 | Central Dupage Physician Group | Orthopaedic Surgery | 515 Thornhill Dr, Carol Stream, IL 60188-2703 | 2012-11-26 |
| 1780012344 | Central Dupage Physician Group | Orthopaedic Surgery | 351 Delnor Dr, Geneva, IL 60134-4222 | 2013-10-17 |
| 1477897833 | Central Dupage Physician Group | Orthopaedic Surgery | 885 Roosevelt Rd, Suite 300, Glen Ellyn, IL 60137-6141 | 2012-11-23 |
| 1841534203 | Central Dupage Physician Group | Orthopaedic Surgery | 27650 Ferry Rd, Warrenville, IL 60555-3845 | 2012-11-23 |
| 1750625117 | Central Dupage Physician Group | Orthopaedic Surgery | 7 Blanchard Cir, Suite 101, Wheaton, IL 60189-2037 | 2012-11-23 |
| 1194069559 | Central Dupage Physician Group | Orthopaedic Surgery | 101 E 75th St, Suite 100, Naperville, IL 60565-1469 | 2012-11-23 |
| 1831433291 | Central Dupage Physician Group | Orthopaedic Surgery | 820 S Il Route 59, Suite 320, Bartlett, IL 60103-1694 | 2012-11-23 |
| Street Address |
5777 DEPARTMENT |
| City | CAROL STREAM |
| State | IL |
| Zip Code | 60122-5777 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841419207 | West Suburban Medical Center | Obstetrics & Gynecology | Box 4063 Women's Health Center, Carol Stream, IL 60122-0001 | 2007-04-24 |
| 1073546016 | Christine Margaret Abt | Clinical Nurse Specialist | Advance Psychiatry and Counseling, Billing Dept. 5973, Carol Stream, IL 60122-0001 | 2006-07-09 |
| 1972834497 | Robin E Theis | Occupational Therapist | 4698 Department, Carol Stream, IL 60122-0021 | 2010-01-22 |
| 1780925446 | Physician Anesthesia Associates Sc | Anesthesiology | 4330 Dept, Carol Stream, IL 60122-4330 | 2013-03-06 |
| 1144208067 | Michelle E Lexmond | Physician Assistant | 4602 Dept, Carol Stream, IL 60122-4602 | 2006-01-03 |
| 1437323896 | Roshni A. Vasaiwala | Ophthalmology | Dept. 4684, Carol Stream, IL 60122-4684 | 2008-04-16 |
| 1740313733 | Central Dupage Health | Pathology | Dept 4003, Carol Stream, IL 60122-4698 | 2007-03-13 |
| 1689732836 | Commonwealth Ear Nose & Throat-head & Neck Center | Otolaryngology | Department 8033, Carol Stream, IL 60122-8033 | 2006-12-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548860729 | New Gen Ed Inc. | Substance Abuse Rehabilitation Facility | 1219 N Gary Ave, Carol Stream, IL 60188-9028 | 2020-10-28 |
| 1568076545 | Ana Martinez | Dietitian, Registered | 750 Iroquois Trl, Carol Stream, IL 60188-9117 | 2020-09-07 |
| 1598379075 | Patient Builders Marketing | Skilled Nursing Facility | 800 W Army Trail Rd, Carol Stream, IL 60188-9040 | 2020-09-02 |
| 1669094850 | Rawalji Inc | Chiropractor | 735 Buffalo Cir, Carol Stream, IL 60188-9105 | 2020-05-11 |
| 1104446251 | Stephanie Czernek | Occupational Therapist | 330 Shawnee Dr, Carol Stream, IL 60188-1967 | 2020-04-19 |
| 1194345249 | Kalee Sweeney | Student in an Organized Health Care Education/Training Program | 1114 Bradbury Cir, Carol Stream, IL 60188-3904 | 2020-04-19 |
| 1801416045 | Midwest Coach Builders, Inc | Durable Medical Equipment & Medical Supplies | 200 Easy St Ste I, Carol Stream, IL 60188-2399 | 2020-04-17 |
| 1568082782 | Lisa Chico Couseling Services, LLC | Social Worker | 468 N Silverleaf Blvd, Carol Stream, IL 60188-3420 | 2020-04-17 |
| 1821624768 | Ryan Timothy Atkins | Physician Assistant | 714 Bluff St Apt 303, Carol Stream, IL 60188-3429 | 2020-03-22 |
| 1306470588 | Restore Therapy and Wellness Services | Occupational Therapist | 671 Tacoma Dr, Carol Stream, IL 60188-4743 | 2020-02-27 |
| Find all providers in CAROL STREAM | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588145197 | Rita D Patel | Family Medicine | 858 Papoose Ct., Carol Stream, IL 60188 | 2018-08-22 |
| 1982879029 | Dupage Health Center Ltd | Family Medicine | 206 N Gary Ave, Carol Stream, IL 60188-1834 | 2008-04-29 |
| 1093800187 | Patrick F Bednar | Family Medicine | 517 Thornhill Dr, Carol Stream, IL 60188-2703 | 2006-10-04 |
| 1205920196 | Pratima Shah | Family Medicine | 839 Burning Trl, Carol Stream, IL 60188-9148 | 2006-10-03 |
| 1609974310 | Ashwin B Damania | Family Medicine | 511 Thornhill Drive, Suite D, Carol Stream, IL 60188 | 2006-09-20 |
| 1023110731 | John Blaise Pace | Family Medicine | 560 Belmont Ln, Carol Stream, IL 60188 | 2006-09-02 |
| 1427445501 | Physicians Care At Home Inc | Family Medicine | 575 Thornhill Dr, 206, Carol Stream, IL 60188-2763 | 2015-04-16 |
| 1851704043 | Shagufta Naaz Khader | Family Medicine | 630 E North Ave, Dept of Family Medicine, Carol Stream, IL 60188 | 2014-06-05 |
| 1184981417 | Adventist Health Partners, Inc | Family Medicine | 327 Gundersen Dr, Suite C, Carol Stream, IL 60188-2402 | 2012-04-11 |
| 1184752404 | Pratima M Shah Mdsc | Family Medicine | 839 Burning Trl, Carol Stream, IL 60188-9148 | 2007-02-28 |
| Find all providers in CAROL STREAM | ||||
| City | CAROL STREAM |
| Zip Code | 60122 |
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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.