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NPI Code Detail

MEDICARE: RUSH UNIVERSITY MEDICAL CENTER

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
12085R0001XRadiation Oncology Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
101620122OTHERILBLUE CROSS PPO

General Provider Information

NPI Number : 1992771117
Entity Type Code : Organization
Provider Name (Legal Business Name) : RUSH UNIVERSITY MEDICAL CENTER
Provider Business Mailing Address
First Line : 520 S PAULINA ST
Second Line :
City : CHICAGO
State : IL
Zip : 60612-3804
Country : US
Telephone Number : 312-942-5751
Fax Number :
Provider Business Practice Location Address
First Line : 520 S PAULINA ST
Second Line :
City : CHICAGO
State : IL
Zip : 60612-3804
Country : US
Telephone Number : 312-942-5751
Fax Number :
Authorized Official
Title or Position : AUTHORIZED OFFICIAL
Name : BRIAN T SMITH
Credential :
Telephone Number : 312-942-6909
Provider Enumeration Date : 02/27/2006
Last Update Date : 10/04/2013

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Directions to “RUSH UNIVERSITY MEDICAL CENTER ” Practice Location

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