Active NPI
Rush-Copley Medical Group
- Obstetrics Physician
- Aurora, IL
National Provider Identifier
1376643767
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics Physician
- 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, 2018
- Organization subpart
- Yes
- Parent organization
- RUSH-COPLEY MEDICAL GROUP
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics Physician | 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 ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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.
-
- Hematology & Oncology Physician
- Yorkville, IL
- NPI 1093815482
O20040310001029
-
- Sports Medicine (Physical Medicine & Rehabilitation) Physician
- Aurora, IL
- NPI 1376894501
O20040310001029
-
- Otolaryngology/Facial Plastic Surgery Physician
- Yorkville, IL
- NPI 1528105723
O20040310001029
-
- Otolaryngology/Facial Plastic Surgery Physician
- Aurora, IL
- NPI 1942301270
O20040310001029
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 14D0901307 | Rush-Copley Medical Group | Provider-performed microscopy | May 21, 2027 |
| 14D0982030 | Rush Copley Medical Group | Certificate of waiver | Jan 29, 2028 |
| 14D2298354 | Rush Copley Medical Group Dermatology | Certificate of waiver | Feb 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
- Rush Copley Cardiovascular Consultants, LLC (Fox Valley Cardiovascular Consultants)
- Rush Copley Medical Group
- Rush-Copley Hospitalists, LLC
- Rush-Copley Medical Group
- Rush-Copley Medical Group
- Rush-Copley Medical Group
- Rush-Copley Medical Group
- Rush-Copley Medical Group
- Rush-Copley Medical Group
- Rush-Copley Medical Group
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.