Individual provider Active NPI

Carolyn O'Connor, PA-C

  • Medical Physician Assistant
  • Naperville, IL
National Provider Identifier
1881929313
Registry record updated Dec 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
085.003626 Issued in IL
Practice address
100 Spalding Dr
Suite 110
Naperville, IL 60540-6550
Phone
(630) 369-1501
Fax
(630) 369-1560
NPI assigned
Oct 16, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 085.003626 IL Primary

Addresses

Primary practice location

100 Spalding Dr
Suite 110
Naperville, IL 60540-6550

Mailing address

100 Spalding Dr
Suite 110
Naperville, IL 60540-6550
Phone (630) 369-1501

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address coconnor205238@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20091228000421 IL Practitioner - Physician Assistant 6002956968 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advocate Health and Hospitals CorporationGroup PAC ID 7810800935, 3,081 clinicians

Practice addresses (Care Compare)

1221 N Highland Ave
Aurora, IL 60506-1404
Phone (844) 376-3876

214 McHenry Rd
Buffalo Grove, IL 60089-6748
Phone (847) 459-1160

Hospital & facility affiliations

  • Advocate Christ Hospital & Medical Center Hospital, Oak Lawn, IL, CCN 140208
  • Advocate Good Samaritan Hospital Hospital, Downers Grove, IL, CCN 140288

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
085.003626ILMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Advocate Health & Hospitals Corp. CurrentSince Nov 13, 2017 Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Nov 13, 2017 Accepting new patients

Locations

214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160

29373 Network Pl
Chicago, IL 60673

3745 Highland Ave
Fl 2
Downers Grove, IL 60515
Phone (630) 275-2300

100 Spalding Dr
Ste 110
Naperville, IL 60540
Phone (630) 369-1501

Interoperability endpoints

  • Direct secure messaging: coconnor205238@direct.myadvocateaurora.org

Organizations & group practices 3

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1255651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639872000000",
    "number": "1881929313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 SPALDING DR",
            "address_2": "SUITE 110",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605406550",
            "telephone_number": "630-369-1501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 SPALDING DR",
            "address_2": "SUITE 110",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605406550",
            "telephone_number": "630-369-1501",
            "fax_number": "630-369-1560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'CONNOR",
        "first_name": "CAROLYN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-16",
        "last_updated": "2021-12-19",
        "certification_date": "2021-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IL",
            "license": "085.003626",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "coconnor205238@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3745 Highland Ave Fl 2",
            "city": "Downers Grove",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605151584",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "3745 Highland Ave Fl 2",
            "city": "Downers Grove",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605151584",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

Verify at the official NPI Registry.