DUPAGE MEDICAL GROUP, LTD. NPI 1013152537

Durable Medical Equipment & Medical Supplies in Plainfield, IL

NPI 1013152537 Organization Durable Medical Equipment & Medical Supp... CLIA Number 14D2111850 CLIA Certificate of Waiver

About DUPAGE MEDICAL GROUP, LTD.

Dupage Medical Group, Ltd. is a provider established in Plainfield, Illinois specializing in durable medical equipment & medical supplies. The NPI number of Dupage Medical Group, Ltd. is 1013152537 and was assigned on December 2008. The practitioner's primary taxonomy code is 332B00000X with license number 042000124 (IL). The provider is registered as an organization and their NPI record was last updated 9 years ago. The authorized official of this NPI record is Michael Pacetti (Cfo)

The CLIA number of Dupage Medical Group, Ltd. is 14D2111850 registered as a "physician office" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to Dupage Medical Group, Ltd. to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

NPI

1013152537

Provider NameDUPAGE MEDICAL GROUP, LTD.
Provider Location Address24600 W 127TH ST 225 PLAINFIELD, IL 60585
Provider Mailing Address1860 PAYSPHERE CIR CHICAGO, IL 60674
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?Yes
Enumeration Date12-12-2008
Last Update Date09-26-2012


Primary Taxonomy

Taxonomy Code332B00000X
ClassificationDurable Medical Equipment & Medical Supplies
TypeSuppliers
License No.042000124
License StateIL
Taxonomy DescriptionA supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.

Business Address

DUPAGE MEDICAL GROUP, LTD.
24600 W 127TH ST
225
PLAINFIELD, IL
ZIP 60585
Phone: (630) 469-9200

Get Directions


Mailing Address

DUPAGE MEDICAL GROUP, LTD.
1860 PAYSPHERE CIR
CHICAGO, IL
ZIP 60674
Phone:



Authorized Official

Authorized Official Name MICHAEL PACETTI
Authorized Official TitleCFO
Authorized Official Phone(630) 469-9200

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for the NPI number 1013152537 is:

CLIA Number14D2111850
Facility TypePHYSICIAN OFFICE
Certificate TypeCertificate of Waiver

Secondary Taxonomies


The secondary taxonomy codes define the provider type, classification, and specialization. For individual NPIs the license data is associated to each taxonomy code.

No. Taxonomy Code Type Classification Specialization License No. State Primary
1335E00000XSuppliersProsthetic/Orthotic Supplier042000124ILNo

Taxonomy Description: 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.

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
6180250003MEDICARE NSC (07)IL
785110OTHER (01)IL

Other Providers at the same location


The following 20 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1104823780DR. STEVEN MATTHEW KOVAR M.D.
Individual
Pediatrics24600 W 127TH ST BUILDING B, SUITE 345
PLAINFIELD, IL 60585
(815) 609-5437
1154321339DR. KRISTINE NOEL LIBERTY M.D.
Individual
Pediatrics24600 W 127TH ST BUILDING B SUITE 345
PLAINFIELD, IL 60585
(815) 609-5437
1972599520 ROBERT A. OPPENHEIM M.D.
Individual
Ophthalmology24600 W 127TH ST BLDG. B, SUITE 120
PLAINFIELD, IL 60585
(815) 609-6989
1508875048DR. DAVID MICHAEL BURT MD
Individual
Orthopaedic Surgery24600 W 127TH ST BUILDING B, SUITE 240
PLAINFIELD, IL 60585
(815) 267-8825
1417047598KIDS FIRST PEDIATRICS, LTD
Organization
Pediatrics24600 W 127TH ST BUILDING B, SUITE 345
PLAINFIELD, IL 60585
(815) 609-5437
1225108251EDWARD HEALTH VENTURES
Organization
Psychiatry & Neurology (Psychiatry)24600 W 127TH ST STE B325
PLAINFIELD, IL 60585
(815) 731-9100
1215007505SUSAN FEDINEC, D.O. LLC
Organization
Clinic/Center24600 W 127TH ST BLDG B SUITE 340
PLAINFIELD, IL 60585
(815) 676-2940
1730207820 KELLI MARIE KELLER MD
Individual
Psychiatry & Neurology (Psychiatry)24600 W 127TH ST STE B325
PLAINFIELD, IL 60585
(815) 731-9100
1124284203DR. NEENA WILL M.D.
Individual
Specialist24600 W 127TH ST BLDG B SUITE 240
PLAINFIELD, IL 60585
(815) 267-8830
1518283597EDWARD HOSPITAL IMAGING CENTER PLAINFIELD
Organization
Clinic/Center (Radiology)24600 W 127TH ST
PLAINFIELD, IL 60585
(815) 731-3000
1548565880 CHRISTINE MARIE DAHL APN
Individual
Nurse Practitioner (Psychiatric/Mental Health)24600 W 127TH ST STE B325
PLAINFIELD, IL 60585
(815) 731-9100
1447269915DR. RAGHU R PULLURU M.D.
Individual
Orthopaedic Surgery24600 W 127TH ST SUITE 225
PLAINFIELD, IL 60585
(630) 790-1872
1821174285DR. CRAIG KESTENBERG DO
Individual
Psychiatry & Neurology (Child & Adolescent Psychiatry)24600 W 127TH ST STE B325
PLAINFIELD, IL 60585
(815) 731-9100
1376707448DR. JESSICA LYNN KAPPELMAN MD, MPH
Individual
Dermatology24600 W 127TH ST BUILDING B SUITE 335
PLAINFIELD, IL 60585
(815) 676-6716
1780948588NAVROW L.L.C.
Organization
Specialist24600 W 127TH ST BUILDING B SUITE 335
PLAINFIELD, IL 60585
(815) 676-6716
1336588532EDWARD HEALTH SERVICES CORPORATION
Organization
Non-Pharmacy Dispensing Site24600 W 127TH ST
PLAINFIELD, IL 60585
(630) 646-3888
1841630589EDWARD HEALTH VENTURES
Organization
Obstetrics & Gynecology24600 W 127TH ST STE 125
PLAINFIELD, IL 60585
(630) 961-9485
1497029193 GINA WILKINS NP
Individual
Family Medicine24600 W 127TH ST SUITE 100
PLAINFIELD, IL 60585
(815) 713-9000
1043632136EDWARD HEALTH VENTURES
Organization
Neurological Surgery24600 W 127TH ST STE B205
PLAINFIELD, IL 60585
(815) 731-9120
1033510466 CAROL WILLS RNFA
Individual
Registered Nurse (Registered Nurse First Assistant)24600 W 127TH ST BLDG B, STE 240
PLAINFIELD, IL 60585
(815) 267-8830

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.