Provider Demographics
NPI:1033149844
Name:CENTRAL DUPAGE PHYSICIAN GROUP
Entity type:Organization
Organization Name:CENTRAL DUPAGE PHYSICIAN GROUP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PREIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:TOWNE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-933-1600
Mailing Address - Street 1:5777 DEPARTMENT
Mailing Address - Street 2:
Mailing Address - City:CAROL STREAM
Mailing Address - State:IL
Mailing Address - Zip Code:60122-5777
Mailing Address - Country:US
Mailing Address - Phone:630-933-3300
Mailing Address - Fax:630-933-2740
Practice Address - Street 1:5777 DEPARTMENT
Practice Address - Street 2:
Practice Address - City:CAROL STREAM
Practice Address - State:IL
Practice Address - Zip Code:60122-5777
Practice Address - Country:US
Practice Address - Phone:630-933-3300
Practice Address - Fax:630-933-2740
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-04
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Multi-Specialty
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Multi-Specialty
No207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Multi-Specialty
No207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Multi-Specialty
No207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic OncologyGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
No2083S0010XAllopathic & Osteopathic PhysiciansPreventive MedicineSports MedicineGroup - Multi-Specialty
No2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiologyGroup - Multi-Specialty
No2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional RadiologyGroup - Multi-Specialty
No208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL080116892OtherMEDICARE RAILROAD MWB
ID0222075OtherBLUE CROSS GROUP NUMBER
ID0222075OtherBLUE CROSS GROUP NUMBER
IL=========OtherTAX IDENTIFICATION NUMBER
IL920540Medicare ID - Type UnspecifiedGROUP NUMBER
IL208015Medicare PIN
IL206147Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER
IL=========6019001Medicaid
IL367760Medicare ID - Type UnspecifiedGROUP NUMBER
ID0222075OtherBLUE CROSS GROUP NUMBER
IL509110Medicare ID - Type UnspecifiedGROUP NUMBER
IL482450Medicare ID - Type UnspecifiedGROUP NUMBER