DUPAGE MEDICAL GROUP LTD NPI 1700839230

NPI Information

DUPAGE MEDICAL GROUP, LTD is a multi-specialty clinic center in Blue Island, IL. DUPAGE MEDICAL GROUP, LTD NPI is 1700839230. The provider is registered as an organization entity type.
The provider Is Doing Business As Dupage Medical Group, Ltd.

The provider's business location address is:

2320 HIGH ST
BLUE ISLAND, IL
ZIP 60406-426
Phone: (708) 388-5500
Fax: (708) 388-5672

The provider's authorized official is Mike Pacetti .
The authorized official title is Cfo and has the following contact phone number (630) 942-7917.

The CLIA number assigned to this NPI record is 14D2131900 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 5/18/2006 and was last updated on 12/1/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

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