Active NPI
Rush-Copley Medical Group
- Pediatrics Physician
- Aurora, IL
National Provider Identifier
1982974689
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 036128969
- Legal business name
- RUSH-COPLEY MEDICAL GROUP
- Practice address
- 2040 Ogden Ave
Suite 215
Aurora, IL 60504-7206 - Phone
- (630) 375-2844
- Fax
- (630) 375-2808
- NPI assigned
- Jan 11, 2012
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Marcee A Brummel
- Title
- Executive Director
- Phone
- (630) 978-4915
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 036128969 | IL | Primary |
| Pediatric Adolescent Medicine Physician | 2080A0000X | 036128969 | IL |
Addresses
Primary practice location
2040 Ogden Ave
Suite 215
Aurora, IL 60504-7206
Mailing address
1256 Waterford Dr Ste 230
Aurora, IL 60504-4511
Phone (630) 499-2404
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036128969 | Medicaid | IL |
National Provider Directory
National Provider DirectoryLocations
2040 Ogden Ave
Ste 215
Aurora, IL 60504
Phone (630) 375-2844
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1326240000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1519171200000",
"number": "1982974689",
"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 215",
"city": "AURORA",
"state": "IL",
"postal_code": "605047206",
"telephone_number": "630-375-2844",
"fax_number": "630-375-2808"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "RUSH-COPLEY MEDICAL GROUP",
"organizational_subpart": "NO",
"enumeration_date": "2012-01-11",
"last_updated": "2018-02-21",
"status": "A",
"authorized_official_last_name": "BRUMMEL",
"authorized_official_first_name": "MARCEE",
"authorized_official_middle_name": "A",
"authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
"authorized_official_telephone_number": "630-978-4915"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Pediatrics",
"state": "IL",
"license": "036128969",
"primary": true
},
{
"code": "2080A0000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Pediatrics, Adolescent Medicine",
"state": "IL",
"license": "036128969",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036128969",
"state": "IL"
}
],
"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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.