Provider Demographics
NPI:1417914839
Name:RUSH OAK PARK HOSPITAL, INC.
Entity Type:Organization
Organization Name:RUSH OAK PARK HOSPITAL, INC.
Other - Org Name:RUSH OAK PARK PHYSICIANS GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:V.P. MEDICAL AFFAIRS
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SILVER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-718-0200
Mailing Address - Street 1:1730 PARK ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-2688
Mailing Address - Country:US
Mailing Address - Phone:630-718-0200
Mailing Address - Fax:630-718-0900
Practice Address - Street 1:610 S MAPLE AVE
Practice Address - Street 2:SUITE 2100
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60304-1091
Practice Address - Country:US
Practice Address - Phone:708-660-2240
Practice Address - Fax:708-660-2243
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-28
Last Update Date:2011-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01620379OtherBLUE CROSS / BLUE SHIELD
IL01620379OtherBLUE CROSS / BLUE SHIELD