State: | Illinois |
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Address: | 809 Ogden Ave, Lisle, IL 60532, USA |
Postal code: | 60532 |
Phone: | (630) 873-8748 |
Website: | http://www.dupagemedicalgroup.com/ |
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RecordConnect Copy Service, care of DuPage Medical Group 801 Ogden Avenue, Lisle, IL 60532 Phone: 630-873-8748 Fax: 630-873-8797 Dupage.status@recordconnectinc.com AUTHORIZATION FOR RELEASE OF HEALTH INFORMATION The information that you are requesting may be available through MyChart @https://mychart.dupagemedicalgroup.com.
For questions, please call (630) 873-8748, Monday through Friday, 8AM - 5PM. Please mail completed forms to: DuPage Medical Group Attn: RecordConnect Copy Service 801 Ogden Avenue Lisle, IL 60532. Fees. There are no fees associated with requests for information to be sent directly to another medical provider outside of DMG.
RecordConnect Copy Service, care of DuPage Medical Group 809 Ogden Avenue, Lisle, IL 60532 - 2100 Glenwood Ave, Joliet, IL 60435 Phone: 630-873-8748 Fax: 630-873-8797 Dupage.status@recordconnectinc.com AUTHORIZATION FOR RELEASE OF HEALTH INFORMATION
Authorization Form for Release of Health Information. RecordConnect Copy Service, care of DuPage Medical Group. 809 Ogden Avenue, Lisle, IL 60532.
HealthPort Copy Service DuPage Medical Group 430 Pennsylvania Ave. Glen Ellyn IL. 60137 Ph 630-873-8748 Fax 630-873-8797 AUTHORIZATION FOR RELEASE OF HEALTH INFORMATION The information that you are requesting may be available through your MyChart Account at https //mychart.
Additional copies of previous records can be obtained through our medical record service, RecordConnect, by emailing DuPage.status@recordconnectinc.com, faxing to (630) 873-8797 or by calling (630) 873-8748.
Additional copies of previous records can be obtained through our medical record service, RecordConnect, by emailing DuPage.status@recordconnectinc.com , faxing to (630) 873-8797 or by calling (630) 873-8748.
@ DuPage Medical Group . 809 Ogden Avenue. Lisle, IL 60532. Ph: 630-873-8748 . Fax: 630-873-8797. AUTHORIZATION FOR RELEASE OF HEALTH INFORMATION. The information that you are requesting may be available through your MyChart Account @https:mychart.dupagemedicalgroup.com. If you require additional information, complete this authorization.
HealthPort Copy Service DuPage Medical Group 430 Pennsylvania Ave. Glen Ellyn, IL. 60137 Ph: 630-873-8748 Fax: 630-873-8797 AUTHORIZATION FOR RELEASE OF HEALTH INFORMATION The information that you Fill & Sign Online, Print, Email, Fax, or Download
Name of the Facility: DuPage Medical Group Direct Number: 630-873-8748 press 4 Will confirm patient: NO Copy Service: Healthport Fax Number: 770-689-3407 or 770-873-8797 Mailing Address: HealthPort Copy Service @ DuPage Medical Group 809 Ogden Avenue Lisle, IL60532 Email Address: dupage.status@healthport.com. Prepayment: POSTBILL