Healthcare Provider Details
I. General information
NPI: 1699921007
Provider Name (Legal Business Name): RUSH UNIVERSITY MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/18/2008
Last Update Date: 08/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1653 W CONGRESS PKWY
CHICAGO IL
60612-3833
US
IV. Provider business mailing address
750 PEARSON ST
DES PLAINES IL
60016-9211
US
V. Phone/Fax
- Phone: 312-942-5000
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 174400000X |
| Taxonomy | Specialist |
| License Number | 72721 |
| License Number State | IL |
VIII. Authorized Official
Name:
SHERRI
SACHS
Title or Position: EDUCATION COORDINATOR
Credential:
Phone: 312-942-5000