NPIMap

Organization Active NPI

Rush-Copley Medical Group

  • Otolaryngology/Facial Plastic Surgery Physician
  • Aurora, IL
National Provider Identifier
1942301270
Registry record updated Feb 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology/Facial Plastic Surgery PhysicianTaxonomy code 207YX0905X
Legal business name
RUSH-COPLEY MEDICAL GROUP
Practice address
2040 Ogden Ave
Suite 301
Aurora, IL 60504-7222
Phone
(630) 978-6895
Fax
(630) 375-2905
NPI assigned
Sep 26, 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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X
Otolaryngology/Facial Plastic Surgery Physician 207YX0905X Primary
Audiologist 231H00000X

Addresses

Primary practice location

2040 Ogden Ave
Suite 301
Aurora, IL 60504-7222

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

National Provider Directory

National Provider Directory
Part of
Rush Copley Medical GRP NFP

Locations

1901 W Galena Blvd
Aurora, IL 60506
Phone (630) 692-5960

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1519171200000",
    "number": "1942301270",
    "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": "2040 OGDEN AVE",
            "address_2": "SUITE 301",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605047222",
            "telephone_number": "630-978-6895",
            "fax_number": "630-375-2905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUSH-COPLEY MEDICAL GROUP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RUSH-COPLEY MEDICAL GROUP",
        "enumeration_date": "2006-09-26",
        "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": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207YX0905X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.