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General NPI Number Information
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NPI Number | 1730606583
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Entity Type | Individual
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Provider Name | LEANN R RUSHING PA-C
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Gender | Female
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Dates
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Enumeration Date | 08/23/2017
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Last Update Date | 01/04/2021
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Provider Practice Location Address
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Address Line | 2007 95TH ST STE 105
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City | NAPERVILLE
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State | IL
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Zip | 60564-7802
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Country | US
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Telephone | 630-646-6920
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Fax | 630-548-1749
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Provider Business Mailing Address
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Address Line | 2007 95TH ST STE 105
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City | NAPERVILLE
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State | IL
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Zip | 60564-7802
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Country | US
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Telephone | 630-646-6920
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Fax | 630-548-1749
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 085006324
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License Number State | IL
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