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General NPI Number Information
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NPI Number | 1316067994
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Entity Type | Organization
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Legal Business Name | RUSH UNIVERSITY MEDICAL CENTER
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Dates
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Enumeration Date | 03/29/2007
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Last Update Date | 07/18/2007
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Provider Practice Location Address
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Address Line | 4711 GOLF RD SUITE 1100
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City | SKOKIE
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State | IL
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Zip | 60076-1224
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Country | US
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Telephone | 847-933-9339
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Fax | 847-933-0874
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Provider Business Mailing Address
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Address Line | 4711 GOLF RD SUITE 1100
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City | SKOKIE
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State | IL
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Zip | 60076-1224
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Country | US
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Telephone | 847-933-9339
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Fax | 847-933-0874
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Authorized Official
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Title or Position | CEO
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Name | LARRY GOODMAN
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Credential | MD
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Telephone | 312-924-7073
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282NC2000X
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Taxonomy Name | Children's Hospital
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License Number |
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License Number State |
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