Organization
RUSH-COPLEY MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARCEE A BRUMMEL (EXECUTIVE DIRECTOR)
(630) 499-2404
Entity
Organization
Contact information
Practice address
2040 OGDEN AVE., SUITE 304, AURORA, IL 60504
(630) 236-4270
(630) 236-4271
Mailing address
1256 WATERFORD DR STE 230, AURORA, IL 60504-4511
(630) 499-2404
(630) 692-5518
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
—
—
207RS0010X
Sports Medicine (Internal Medicine) Physician
—
—
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
—
—
2083S0010X
Sports Medicine (Preventive Medicine) Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036-112492
—
IL
Enumeration date
09/27/2012
Last updated
02/21/2018
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