Mary Connolly, M.D.
Individual provider Active NPI Family Medicine Physician · Naperville, IL
NPI 1174790141 · NPPES record last updated Jan 20, 2011
Key facts
- NPI
- 1174790141
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 036121843 (IL)
- Practice address
- 1220 Hobson Rd
204
Naperville, IL 60540-8139 - Phone
- (630) 416-7766
- NPI assigned
- May 9, 2008
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 10
Hospital & facility affiliations 6
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Other, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Morris Hospital
Practice addresses (Care Compare)
25259 S Reed St
Channahon, IL 60410-6003
Phone (815) 467-0555
Hospital & facility affiliations
- Resilience Home Health, LLC
- At Home Quality Care - Morris
- Panoptic Home Health
- Morris Hospital & Healthcare Centers
- Silver Cross Hospital and Medical Centers
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090909000356 | IL | Practitioner - Family Practice | 1254486665 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Morris Hospital | Current | Accepting new patients | |
| Morris Hospital | Current |
Accepting new patients | |
| Morris Hospital | Current | Accepting new patients | |
| Morris Hospital | Family Medicine | Current |
Accepting new patients |
| Dupage Medical Group LTD | Past | Accepting new patients |
Locations
389 E Main St
Braidwood, IL 60408
Phone (815) 458-2532
25259 S Reed St
Channahon, IL 60410
Phone (815) 467-0555
580 Sycamore St
Marseilles, IL 61341
Phone (815) 795-2122
725 School St
Ste A
Morris, IL 60450
150 W High St
Morris, IL 60450
Phone (815) 942-2129
Interoperability endpoints
- mary.connolly@direct-address.org
- mary.connolly.1@14307.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 036121843 | IL | Yes |
Addresses
Primary practice location
1220 Hobson Rd
204
Naperville, IL 60540-8139
Mailing address
1860 Paysphere Cir
Chicago, IL 60674-0018
Phone (630) 416-7766
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036121843 | Medicaid | IL |
Other providers in Naperville, IL
- Compassionate Psychological Services LLC
- Comprehensive Psych Solutions Inc
- Amanda Rae Comstock
- Lazarick Ron'E Coney Jr.
- Connection First Speech and Language Therapy LLC
- Margaret Connors
- Brittany M Conrad
- Tina Conroy
- Conscious Healing PLLC
- Stephanie Contreras
All providers in Naperville, IL · Family Medicine Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 20, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.