=====================================================
General NPI Number Information
=====================================================
NPI Number | 1508067380
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | LASHON RUSHING PHARM. D.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/30/2007
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2330 W BURR OAK
-----------------------------------------------------
City | BLUE ISLAND
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60406
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 708-371-1996
-----------------------------------------------------
Fax | 708-371-1981
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4116 191ST PL
-----------------------------------------------------
City | COUNTRY CLUB HILLS
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60478-5804
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 708-799-1958
-----------------------------------------------------
Fax | 708-371-1981
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 289713
-----------------------------------------------------
License Number State | IL
-----------------------------------------------------