Provider Demographics
NPI:1679239230
Name:COLLEGE OF NURSING FACULTY PRACTICE
Entity Type:Organization
Organization Name:COLLEGE OF NURSING FACULTY PRACTICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SALLY
Authorized Official - Middle Name:
Authorized Official - Last Name:LEMKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-563-6830
Mailing Address - Street 1:300 S ASHLAND AVE STE 101E
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60607-3856
Mailing Address - Country:US
Mailing Address - Phone:312-942-2364
Mailing Address - Fax:
Practice Address - Street 1:3000 S KING DR
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60616-3452
Practice Address - Country:US
Practice Address - Phone:773-534-7202
Practice Address - Fax:312-666-7371
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RUSH UNIVERSITY MEDICAL CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-11-09
Last Update Date:2021-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center