Laura Lee Connolly, PAC
Individual provider Active NPI Surgical Physician Assistant · Westchester, IL
NPI 1255398558 · NPPES record last updated Nov 16, 2009
Key facts
- NPI
- 1255398558
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Surgical Physician Assistant 363AS0400X
- License
- 085002150 (IL)
- Practice address
- 3 Westbrook Corporate Ctr
Ste 1000
Westchester, IL 60154-5703 - Phone
- (708) 343-3566
- Fax
- (708) 343-9235
- NPI assigned
- Apr 28, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Endeavor Health Medical Group
Practice addresses (Care Compare)
120 Spalding Dr
Suite 205And207
Naperville, IL 60540-6508
Phone (630) 646-6020
155 E Brush Hill Rd
Elmhurst, IL 60126-5658
Phone (331) 221-0096
177 E Brush Hill Rd
Elmhurst, IL 60126-5658
Phone (630) 646-6020
2650 Ridge Ave
Evanston, IL 60201-1700
3122 N Ashland Ave
Chicago, IL 60657-3014
Phone (773) 687-0999
5115 N Francisco
Garden Pavillon
Chicago, IL 60625-3611
Phone (773) 989-5571
5115 N Francisco Ave
Chicago, IL 60625-3611
Phone (847) 570-1440
5140 N California
Suite G600
Chicago, IL 60625-3645
Phone (773) 989-3803
5140 N California Ave
Chicago, IL 60625-3645
801 S Washington St
Naperville, IL 60540-7430
Phone (630) 527-5197
9600 Gross Point Rd
Skokie, IL 60076-1214
Hospital & facility affiliations
- Swedish Hospital
- Edward Hospital
- Northshore University Healthsystem - Evanston Hospital
- Elmhurst Memorial Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 84.9 of 100
- Quality
- 75.91
- Promoting interoperability
- 99
- Improvement activities
- 40
- Cost
- 74.6
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: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040217000060 | IL | Practitioner - Physician Assistant | 2365337664 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Endeavor Health Medical Group | Current |
Accepting new patients | |
| Gottlieb Community Health Services Corporation | Past | Accepting new patients |
Locations
5115 N Francisco Ave
Chicago, IL 60625
Phone (773) 271-2225
9532 Eagle Way
Chicago, IL 60678
2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222
2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206
Interoperability endpoints
- laura.connolly.1@18732.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | 085002150 | IL | Yes |
Addresses
Primary practice location
3 Westbrook Corporate Ctr
Ste 1000
Westchester, IL 60154-5703
Mailing address
3 Westbrook Corporate Ctr
Ste 1000
Westchester, IL 60154-5703
Phone (708) 343-3566
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 085002150 | Medicaid | IL |
Other providers in Westchester, IL
- Chicagoland Integrated Professionals, Inc
- Christa Holberg Pediatric Therapy L.L.C
- Craig C Christiansen
- Elaine Carol Ciupik
- Community Care Home Health Services, Inc.
- Melissa L Conrad
- Diana Contreras
- Core Id Group LLC
- Covenant Intuition Center
- Covid Drive Up Testing
All providers in Westchester, IL · Surgical Physician Assistant in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 16, 2009. 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.