MEDICARE: RUSH UNIVERSITY MEDICAL CENTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261Q00000X	Clinic/Center		IL

General Provider Information

NPI Number	:	1962762047
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RUSH UNIVERSITY MEDICAL CENTER

Provider Business Mailing Address
First Line	:	1321 S PAULINA ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60608-1221
Country	:	US
Telephone Number	:	773-534-7202
Fax Number	:	312-666-7371

Provider Business Practice Location Address
First Line	:	1321 S PAULINA ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60608-1221
Country	:	US
Telephone Number	:	773-534-7202
Fax Number	:	312-666-7371

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	BRIAN T SMITH
Credential	:
Telephone Number	:	312-942-6909

Provider Enumeration Date	:	05/22/2012
Last Update Date	:	05/22/2012

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