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FAMILY MEDICAL CENTER OF LAGRANGE LTD
NPI 1649355793
Family Medicine in Lagrange, IL

Active since October 26, 2006CLIA 14D0880380 · Waiver
5201 S WILLOW SPRINGS ROAD, SUITE 300, LAGRANGE, IL 60525(708) 482-8088(708) 482-9034 Get Directions Write a Review

NPPES record last updated: November 5, 2012. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Family Medical Center Of Lagrange Ltd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

FAMILY MEDICAL CENTER OF LAGRANGE LTD (NPI 1649355793) is a healthcare organization registered as a family medicine in Lagrange, Illinois and active in the NPI registry since October 2006. The organization holds a CLIA Waiver certificate valid through December 9, 2027 and lists Michael Francis Dupont, Vice President Physician, as its authorized official.

NPPES Registry Identity

NPI1649355793
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameFAMILY MEDICAL CENTER OF LAGRANGE LTD
Location Address5201 S WILLOW SPRINGS ROAD, SUITE 300Lagrange, IL 60525
Mailing Address5201 S Willow Springs Road, Suite 300Lagrange, IL 60525 · (708) 482-8088 · Fax (708) 482-9034
Phone(708) 482-8088
Fax(708) 482-9034
Organization SubpartNo
Authorized OfficialMichael Francis DupontVice President Physician · (708) 482-8088
Enumeration DateOctober 26, 2006
Last NPPES UpdateNovember 5, 2012
✔ NPI 1649355793 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
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.
5201 S WILLOW SPRINGS ROAD, Lagrange, IL 60525
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Other Identifiers 1

Medicare ID-Type Unspecified397950IL

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Family Medical Center Of Lagrange Ltd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

5

Medicare enrollment records show 5 clinicians reassign Medicare billing to Family Medical Center Of Lagrange Ltd, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 5 within 10 miles. They are listed nearest first.

Clinicians, nearest first (5)

Samuel Traverso, DO
Family Practice
NPI 1902464647
5201 WILLOW SPRINGS RD STE 300
La Grange Highlands, IL 60525
(708) 482-8088
✔ PECOS✔ Accepts MedicareSame address
Prachi Patel, D.O.
Family Practice
NPI 1144545849
5101 WILLOW SPRINGS RD 2ND FLOOR
La Grange, IL 60525
(708) 245-8900
✔ PECOS✔ Accepts Medicare0.1 mi
Michael Dupont, MD
Family Practice
NPI 1508817750
5201 WILLOW SPRINGS RD SUITE 300
La Grange Highlands, IL 60525
(708) 482-8088
✔ PECOS✔ Accepts Medicare0.1 mi
Daniel Chen, DO
Family Practice
NPI 1356355812
5201 WILLOW SPRINGS RD STE 180
La Grange Highlands, IL 60525
(708) 929-6099
✔ PECOS✔ Accepts Medicare0.1 mi
Scott Robertson, DO
Family Practice
NPI 1376553875
5201 WILLOW SPRINGS RD STE 180
La Grange Highlands, IL 60525
(708) 929-6099
✔ PECOS✔ Accepts Medicare0.1 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 14D0880380

Family Medical Center Of Lagrange Ltd · La Grange, IL
Active · expires Dec 9, 2027
CLIA Number14D0880380
Laboratory TypePhysician Office
Certificate Effective DateDecember 10, 2025
Certificate Expiration DateDecember 9, 2027
Laboratory DirectorMichael F. Dupont M D
Laboratory Phone(708) 482-8088
Laboratory LocationFamily Medical Center Of Lagrange Ltd5201 Willow Springs Suite 300, La Grange, IL 60525
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Family Medical Center Of Lagrange Ltd's NPI number?

The NPI number for Family Medical Center Of Lagrange Ltd is 1649355793. It was assigned to this organization in the NPPES registry on October 26, 2006.

Where is Family Medical Center Of Lagrange Ltd located?

Family Medical Center Of Lagrange Ltd is located at 5201 S Willow Springs Road Suite 300, Lagrange, IL 60525. The listed phone number is (708) 482-8088.

What is Family Medical Center Of Lagrange Ltd's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Family Medical Center Of Lagrange Ltd enrolled in Medicare?

Yes. Family Medical Center Of Lagrange Ltd is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Family Medical Center Of Lagrange Ltd?

According to the CMS Revalidation Reassignment List (October 2026 release), 5 clinicians, all in Family Practice, reassign their Medicare billing to Family Medical Center Of Lagrange Ltd. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 1 practice at this address and 5 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Family Medical Center Of Lagrange Ltd hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 14D0880380) is associated with this NPI, valid through December 9, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Family Medical Center Of Lagrange Ltd was last updated on November 5, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.