Provider Demographics
NPI:1295865079
Name:DUPAGE INTERNAL MEDICINE, LTD.
Entity type:Organization
Organization Name:DUPAGE INTERNAL MEDICINE, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING
Authorized Official - Prefix:
Authorized Official - First Name:SHERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:LOW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-668-3213
Mailing Address - Street 1:517 THORNHILL DR
Mailing Address - Street 2:
Mailing Address - City:CAROL STREAM
Mailing Address - State:IL
Mailing Address - Zip Code:60188-2703
Mailing Address - Country:US
Mailing Address - Phone:630-668-3210
Mailing Address - Fax:630-668-3505
Practice Address - Street 1:517 THORNHILL DR
Practice Address - Street 2:
Practice Address - City:CAROL STREAM
Practice Address - State:IL
Practice Address - Zip Code:60188-2703
Practice Address - Country:US
Practice Address - Phone:630-668-3210
Practice Address - Fax:630-668-3505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207R00000X, 207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Not Answered207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
777480Medicare ID - Type Unspecified