Provider Demographics
NPI:1659619401
Name:RUSHANI, QANI (DC)
Entity Type:Individual
Prefix:DR
First Name:QANI
Middle Name:
Last Name:RUSHANI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:77 W WASHINGTON ST
Mailing Address - Street 2:#1704
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60602-2801
Mailing Address - Country:US
Mailing Address - Phone:630-865-3479
Mailing Address - Fax:312-977-2101
Practice Address - Street 1:77 W WASHINGTON ST
Practice Address - Street 2:#1704
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60602-2801
Practice Address - Country:US
Practice Address - Phone:312-977-2100
Practice Address - Fax:312-977-2101
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-29
Last Update Date:2013-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038012282111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor