Provider Demographics
NPI:1508817750
Name:DUPONT, MICHAEL FRANCIS (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:FRANCIS
Last Name:DUPONT
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:5201 WILLOW SPRINGS RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:LA GRANGE HIGHLANDS
Mailing Address - State:IL
Mailing Address - Zip Code:60525-6537
Mailing Address - Country:US
Mailing Address - Phone:708-482-8088
Mailing Address - Fax:708-482-9034
Practice Address - Street 1:5201 WILLOW SPRINGS RD
Practice Address - Street 2:SUITE 300
Practice Address - City:LA GRANGE HIGHLANDS
Practice Address - State:IL
Practice Address - Zip Code:60525-6537
Practice Address - Country:US
Practice Address - Phone:708-482-8088
Practice Address - Fax:708-482-9034
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2012-11-05
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Provider Licenses
StateLicense IDTaxonomies
IL36085104207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036085104Medicaid
IL036085104Medicaid