Kimberlie Connell, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

085003440 Issued in IL

Practice address

2040 Ogden Ave Ste 115
Aurora, IL 60504-7205

Phone

(630) 922-8825

Fax

(630) 369-8838

NPI assigned

Jun 28, 2010

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Kimberlie Liebert Former name

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Rush University Medical GroupGroup PAC ID 5496658874, 1,521 clinicians

Rush-Copley Medical Group NFPGroup PAC ID 7618864877, 101 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Copley Memorial Hospital Hospital, Aurora, IL, CCN 140029
• Rush University Medical Center Hospital, Chicago, IL, CCN 140119

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Rush University Medical Group

  dba Rush University Internists

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1093819542
  Medicare reassignment Care Compare group NPD
• Rush-Copley Medical Group, NFP

  • Family Medicine Physician
  • Aurora, IL
  • NPI 1093075848
  Medicare reassignment Care Compare group NPD
• Rush University Medical Center

  dba Radiology Services

  • Diagnostic Radiology Physician
  • Chicago, IL
  • NPI 1184269425
  NPD
• Rush Copley Medical Group

  • Family Medicine Physician
  • Aurora, IL
  • NPI 1194836247
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Copley Memorial Hospital, Inc.

  • General Acute Care Hospital
  • Aurora, IL
  • NPI 1295882561
  Care Compare affiliation
• Rush University Medical Center

  • Children's Hospital
  • Chicago, IL
  • NPI 1801908728
  Care Compare affiliation
• Rush University Medical Center

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1932213600
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1277683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675036800000",
    "number": "1346551090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2040 OGDEN AVE STE 115",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605047205",
            "telephone_number": "630-922-8825",
            "fax_number": "630-369-8838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2040 OGDEN AVE STE 115",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605047205",
            "telephone_number": "630-922-8825",
            "fax_number": "630-369-8838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNELL",
        "first_name": "KIMBERLIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-28",
        "last_updated": "2023-01-30",
        "certification_date": "2023-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085003440",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLIE",
            "last_name": "LIEBERT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Physician Assistant in Aurora, IL
• Providers in Aurora, IL by specialty
• Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.