DUPAGE MEDICAL GROUP, LTD. (NPI# 1851536379) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851536379 |
| Entity Type | Organization |
| Organization Name | DUPAGE MEDICAL GROUP, LTD. |
| Practice Address |
636 Raymond Dr 300 Naperville IL 60563-9789 |
| Mailing Address |
1860 Paysphere Cir Chicago IL 60674-0018 |
| Practice Telephone | 6305106929 |
| Enumeration Date | 2008-12-12 |
| 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 |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | 042000124 | IL | Suppliers |
| Y | 335E00000X | Prosthetic/Orthotic Supplier | 042000124 | IL | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | MEDICARE GROUP NUMBER | 785110 | 01 |
| IL | MEDICARE GROUP NUMBER | 568660 | 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 |
636 RAYMOND DR 300 |
| City | NAPERVILLE |
| State | IL |
| Zip Code | 60563-9789 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447250642 | Sean Patrick Mccormick | Pediatrics | 636 Raymond Dr, Suite 205, Naperville, IL 60563-9789 | 2005-07-28 |
| 1528465614 | Melissa Mandra | Audiologist | 636 Raymond Dr, Suite 203, Naperville, IL 60563-9789 | 2014-12-04 |
| 1407269939 | Lauren Marie Panner | Registered Nurse | 636 Raymond Dr, Naperville, IL 60563-9791 | 2014-06-02 |
| 1740523539 | Jill Katherine Cotseones | Dermatology | 636 Raymond Dr, Naperville, IL 60563 | 2013-04-01 |
| 1285981167 | Elizabeth J Delass | Physical Therapist | 636 Raymond Dr, Suite 305, Naperville, IL 60563-9789 | 2012-08-09 |
| 1386991552 | Michaela Campagnolo | Physical Therapist | 636 Raymond Dr, Suite 305, Naperville, IL 60563-9789 | 2012-08-07 |
| 1720366636 | Lauren Nicole Taglia | Dermatology | 636 Raymond Dr, Naperville, IL 60563-9791 | 2011-07-26 |
| 1881972990 | Karen L Camporese | Physical Therapist | 636 Raymond Dr, Suite 104a, Naperville, IL 60563-9789 | 2011-07-25 |
| 1023304862 | Molly Purkart | Physical Therapist | 636 Raymond Dr, Suite 200, Naperville, IL 60563-9789 | 2011-06-20 |
| 1659675601 | Kimberly Anne Gubbins | Nurse Practitioner | 636 Raymond Dr, Suite 205, Naperville, IL 60563-9789 | 2011-01-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952902884 | Julia Ann Gottschalk | Nurse Practitioner | 1979 Mcdowell Rd, Unit 103, Naperville, IL 60563 | 2020-11-06 |
| 1700484847 | Lee Michael Harms I | Social Worker | 1952 Mcdowell Road, Suite 305, Naperville, IL 60563 | 2020-10-12 |
| 1881208478 | Poornima Swamy Gangaji | Dentist | 760 N, Illinois Rte 59, Ste100, Naperville, IL 60563 | 2020-09-01 |
| 1851901219 | Adiana Lebron | Social Worker | 2948 Artestian Road, Naperville, IL 60563 | 2020-07-31 |
| 1194342014 | Ingrid Lara | Behavioral Analyst | 1975 Mcdowell Rd #101, Naperville, IL 60563 | 2020-06-26 |
| 1396383030 | Jack Kelly | Assistant Behavior Analyst | 1975 Mcdowell Rd. #101, Naperville, IL 60563 | 2019-12-12 |
| 1316583529 | Arvind Ramakrishnan | Behavioral Analyst | 1975 Mcdowell Rd., Naperville, IL 60563 | 2019-11-22 |
| 1679115778 | Melissa Macias | Behavioral Analyst | 1975 Mcdowell Road, #101, Naperville, IL 60563 | 2019-10-10 |
| 1629619275 | Meghann Reid Vizintos | Physician Assistant | 1763 Freedom Dr Ste 117, Naperville, IL 60563 | 2019-10-04 |
| 1417413543 | Vikram Singh Cheema | Physician Assistant | 1335 North Mill Street, Naperville, IL 60563 | 2019-02-13 |
| Find all providers in zip 60563 | ||||
| Taxonomy Code | 335E00000X |
| Grouping | Suppliers |
| Classification | Prosthetic/Orthotic Supplier |
| An organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition. |
| Notes: Source: American Board for Certification in Orthotics, Prosthetics, and Pedorthics, Inc. [7/1/2010: modified, 7/1/2013: modified] Additional Resources: American Board for Certification in Orthotics, Prosthetics and Pedorthics, Inc., www.abcop.org and Board of Certification/Accreditation, International, www.bocusa.org. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033261912 | Md Orthotic and Prosthetic Laboratories, Inc | Prosthetic/Orthotic Supplier | 622 E Ogden Ave, Naperville, IL 60563 | 2007-01-18 |
| 1972558492 | Orthotics Concepts, Inc. | Prosthetic/Orthotic Supplier | 483 Leprovence Circle, Naperville, IL 60540 | 2006-05-23 |
| 1598720468 | Scheck & Siress Prosthetics, Inc | Prosthetic/Orthotic Supplier | 1551 Bond St Ste 111, Naperville, IL 60563-0150 | 2006-04-20 |
| 1114350261 | Du Page Medical Group Ltd | Prosthetic/Orthotic Supplier | 1259 Rickert Dr, Ste 101, Naperville, IL 60540-8902 | 2013-08-13 |
| 1275878134 | Du Page Medical Group Ltd | Prosthetic/Orthotic Supplier | 1948 Three Farms Ave, Naperville, IL 60540-1105 | 2012-12-04 |
| 1679859029 | Dupage Prosthetic-orthotic Service Inc. | Prosthetic/Orthotic Supplier | 1100 Sherman Ave, Suite 108, Naperville, IL 60563-8608 | 2011-10-31 |
| 1336389204 | Fox Valley Foot Specialists,ltd. | Prosthetic/Orthotic Supplier | 1279 S Naper Blvd, Naperville, IL 60540-8300 | 2009-03-04 |
| 1295970713 | Dupage Medical Group, Ltd. | Prosthetic/Orthotic Supplier | 100 Spalding Dr, 3rd Floor, Naperville, IL 60540-6550 | 2008-12-12 |
| 1396949525 | A Womans Place Inc | Prosthetic/Orthotic Supplier | 619 S Washington St, Naperville, IL 60540-6772 | 2007-06-12 |
| 1790732329 | Gema | Prosthetic/Orthotic Supplier | 1250 N Mill St, Suite 106, Naperville, IL 60563-6304 | 2006-05-28 |
| Find all providers in NAPERVILLE | ||||
| City | NAPERVILLE |
| Zip Code | 60563 |
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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.