Organization
RUSH-COPLEY MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARCEE A BRUMMEL (EXECUTIVE DIRECTOR)
(630) 978-4915
Entity
Organization
Contact information
Practice address
2040 OGDEN AVE, SUITE 215, AURORA, IL 60504-7206
(630) 375-2844
(630) 375-2808
Mailing address
1256 WATERFORD DR STE 230, AURORA, IL 60504-4511
(630) 499-2404
(630) 692-5518
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036128969
IL
2080A0000X
Pediatric Adolescent Medicine Physician
036128969
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036128969
—
IL
Enumeration date
01/11/2012
Last updated
02/21/2018
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