MEDICARE: RUSH UNIVERSITY MEDICAL CENTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261Q00000X	Clinic/Center		IL

General Provider Information

NPI Number	:	1356891618
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RUSH UNIVERSITY MEDICAL CENTER

Provider Business Mailing Address
First Line	:	2333 W JACKSON BLVD
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60612-2957
Country	:	US
Telephone Number	:	312-942-9176
Fax Number	:	312-243-3235

Provider Business Practice Location Address
First Line	:	2333 W JACKSON BLVD
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60612-2957
Country	:	US
Telephone Number	:	312-942-9176
Fax Number	:	312-243-3235

Authorized Official
Title or Position	:	AUTHORIZED OFFICIAL
Name	:	SCOTT A HALPER
Credential	:
Telephone Number	:	312-942-7770

Provider Enumeration Date	:	10/11/2016
Last Update Date	:	10/28/2021

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