Provider Demographics
NPI:1356635577
Name:DUPAGE HEALTH SERVICES, INC.
Entity Type:Organization
Organization Name:DUPAGE HEALTH SERVICES, INC.
Other - Org Name:CDH DELNOR RETAIL HEALTH
Other - Org Type:Other Name
Authorized Official - Title/Position:VP FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:MAUREEN
Authorized Official - Middle Name:
Authorized Official - Last Name:TAUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-933-6342
Mailing Address - Street 1:2900 KIRK RD
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60502-6015
Mailing Address - Country:US
Mailing Address - Phone:630-933-2550
Mailing Address - Fax:
Practice Address - Street 1:2900 KIRK RD
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60502-6015
Practice Address - Country:US
Practice Address - Phone:630-933-2550
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CDH DELNOR HEALTH SYSTEM
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-06-06
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILIL5966OtherMEDICARE PTAN
ILIL7268OtherMEDICARE PTAN
ILIL5966OtherMEDICARE PTAN