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General NPI Number Information
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NPI Number | 1891899522
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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 | 09/12/2006
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Last Update Date | 08/22/2013
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Provider Practice Location Address
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Address Line | 1725 W HARRISON ST SUITE 717
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City | CHICAGO
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State | IL
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Zip | 60612-3841
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Country | US
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Telephone | 312-563-3269
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Fax | 312-563-3272
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Provider Business Mailing Address
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Address Line | 1725 W HARRISON ST SUITE 717
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City | CHICAGO
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State | IL
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Zip | 60612-3841
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Country | US
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Telephone | 312-563-3269
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Fax | 312-563-3272
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | PETER M JOKICH
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Credential | M.D.
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Telephone | 312-563-3269
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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