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General NPI Number Information
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NPI Number | 1629137849
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Entity Type | Organization
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Legal Business Name | RUSH OAK PARK HOSPITAL INC
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Dates
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Enumeration Date | 12/06/2006
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Last Update Date | 01/03/2019
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Provider Practice Location Address
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Address Line | 520 SOUTH MAPLE AVENUE
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City | OAK PARK
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State | IL
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Zip | 60304
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Country | US
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Telephone | 708-660-4700
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Fax | 708-660-4735
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Provider Business Mailing Address
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Address Line | 520 SOUTH MAPLE AVENUE
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City | OAK PARK
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State | IL
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Zip | 60304-1097
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Country | US
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Telephone | 708-660-6633
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Fax | 708-660-6658
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Authorized Official
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Title or Position | PRESIDENT CEO
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Name | MR. BRUCE M ELEGANT
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Credential |
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Telephone | 708-660-6659
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 1744986
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License Number State | IL
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