MEDICARE: MR. JAMES L RUST LCPC

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	101YP2500X	Professional Counselor	180000606	IL

General Provider Information

NPI Number	:	1811045941
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JAMES L RUST LCPC

Provider Business Mailing Address
First Line	:	8 SALT CREEK LN STE 202
Second Line	:
City	:	HINSDALE
State	:	IL
Zip	:	60521-2903
Country	:	US
Telephone Number	:	331-221-2505
Fax Number	:	331-221-2719

Provider Business Practice Location Address
First Line	:	8 SALT CREEK LN STE 202
Second Line	:
City	:	HINSDALE
State	:	IL
Zip	:	60521-2903
Country	:	US
Telephone Number	:	331-221-2505
Fax Number	:	331-221-2719

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/08/2007
Last Update Date	:	02/27/2024

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