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General NPI Number Information
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NPI Number | 1851420319
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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 | 03/02/2007
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Last Update Date | 03/17/2008
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Provider Practice Location Address
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Address Line | 600 S PAULINA ST SUITE 130
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City | CHICAGO
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State | IL
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Zip | 60612-3806
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Country | US
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Telephone | 312-942-3333
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Fax | 312-942-4154
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Provider Business Mailing Address
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Address Line | 600 S PAULINA ST SUITE 130
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City | CHICAGO
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State | IL
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Zip | 60612-3806
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Country | US
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Telephone | 312-942-3333
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Fax | 312-942-4154
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | RAJ C SHAH
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Credential | M.D.
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Telephone | 312-563-2902
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number |
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License Number State |
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