Andrea Irene Rutherford, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

085003364 Issued in IL

Practice address

40 S Clay St
Hinsdale, IL 60521-3257

Phone

(630) 286-5050

Fax

(630) 286-5052

NPI assigned

Mar 9, 2006

Last updated

Jun 17, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Andrea Irene Brezill 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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1141862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655424000000",
    "number": "1720056229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1860 PAYSPHERE CIR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606740018",
            "telephone_number": "630-469-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 S CLAY ST",
            "city": "HINSDALE",
            "state": "IL",
            "postal_code": "605213257",
            "telephone_number": "630-286-5050",
            "fax_number": "630-286-5052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUTHERFORD",
        "first_name": "ANDREA",
        "middle_name": "IRENE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-09",
        "last_updated": "2022-06-17",
        "certification_date": "2022-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IL",
            "license": "96001592",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IL",
            "license": "085003364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANDREA",
            "last_name": "BREZILL",
            "middle_name": "IRENE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Allison Rule, APRN
• Rush-Select Holdings, LLC. (Rush Kids Pediatric Therapy)
• Aubri Ann Rush, MD
• Karen S Russell, D.O.
• James L Rust, LCPC
• John S Rutkauskas, DDS
• Martin Ryan
• Paul D. Ryan, M.D.
• Sydney M Ryan
• Mary Catherine Rybicki, M.P.T.

• Medical Physician Assistant in Hinsdale, IL
• Providers in Hinsdale, IL by specialty
• Medical Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.