Organization Active NPI

Rush-Copley Medical Group

  • Obstetrics Physician
  • Aurora, IL
National Provider Identifier
1376643767
Registry record updated Feb 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics PhysicianTaxonomy code 207VX0000X
Legal business name
RUSH-COPLEY MEDICAL GROUP
Practice address
2020 Ogden Avenue
Suite 225
Aurora, IL 60504
Phone
(630) 978-4800
Fax
(630) 978-6885
NPI assigned
Sep 25, 2006
Last updated
Feb 21, 2018By the provider in NPPES
Organization subpart
Yes
Parent organization
RUSH-COPLEY MEDICAL GROUPAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 21, 2018

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

Authorized official

Name
Marcee Brummel
Title
Exec. Director
Phone
(630) 978-4915

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207VX0000X Primary

Addresses

Primary practice location

2020 Ogden Avenue
Suite 225
Aurora, IL 60504

Mailing address

1256 Waterford Dr Ste 230
Aurora, IL 60504-4511
Phone (630) 499-2404

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040310001029 IL Part B Supplier - Clinic/Group Practice 7618864877 Receives reassigned benefits from 188 practitioners
26 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Aurora, IL; Naperville, IL; North Aurora, IL; Oswego, IL; Plainfield, IL; Sugar Grove, IL; Yorkville, IL

Other NPIs on the same Medicare enrollment 16

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 16

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
14D0901307Rush-Copley Medical Group2020 Ogden Avenue Suite 225, Aurora, IL 60504Provider-performed microscopyMay 21, 2027
14D0982030Rush Copley Medical Group2020 Ogden Avenue Suite 400, Aurora, IL 60504Certificate of waiverJan 29, 2028
14D2298354Rush Copley Medical Group Dermatology2020 Ogden Ave - Set 400, Aurora, IL 60504Certificate of waiverFeb 3, 2028

National Provider Directory

National Provider Directory
Part of
Rush Copley Medical GRP NFP

Locations

1256 Waterford Dr
Ste 230
Aurora, IL 60504
Phone (630) 499-2404

2020 Ogden Ave
Ste 225
Aurora, IL 60504
Phone (630) 978-4800

NPI Registry JSON

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1519171200000",
    "number": "1376643767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1256 WATERFORD DR STE 230",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605044511",
            "telephone_number": "630-499-2404",
            "fax_number": "630-692-5518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 OGDEN AVENUE",
            "address_2": "SUITE 225",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "60504",
            "telephone_number": "630-978-4800",
            "fax_number": "630-978-6885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUSH-COPLEY MEDICAL GROUP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RUSH-COPLEY MEDICAL GROUP",
        "enumeration_date": "2006-09-25",
        "last_updated": "2018-02-21",
        "status": "A",
        "authorized_official_last_name": "BRUMMEL",
        "authorized_official_first_name": "MARCEE",
        "authorized_official_title_or_position": "EXEC. DIRECTOR",
        "authorized_official_telephone_number": "630-978-4915"
    },
    "taxonomies": [
        {
            "code": "207VX0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.