Provider Demographics
NPI:1689140899
Name:MIDWEST ORTHOPAEDICS AT RUSH, LLC
Entity Type:Organization
Organization Name:MIDWEST ORTHOPAEDICS AT RUSH, LLC
Other - Org Name:MIDWEST ORTHOPAEDICS AT RUSH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:COLE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:708-236-2673
Mailing Address - Street 1:1 WESTBROOK CORPORATE CTR STE 240
Mailing Address - Street 2:
Mailing Address - City:WESTCHESTER
Mailing Address - State:IL
Mailing Address - Zip Code:60154-5745
Mailing Address - Country:US
Mailing Address - Phone:708-236-2673
Mailing Address - Fax:
Practice Address - Street 1:18016 WOLF RD
Practice Address - Street 2:
Practice Address - City:ORLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60467-5407
Practice Address - Country:US
Practice Address - Phone:877-632-6637
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-16
Last Update Date:2019-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy