Provider Demographics
NPI:1982657847
Name:RUSH NORTH SHORE MEDICAL CENTER
Entity Type:Organization
Organization Name:RUSH NORTH SHORE MEDICAL CENTER
Other - Org Name:CENTRE FOR WOMEN'S HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:IRMA
Authorized Official - Middle Name:
Authorized Official - Last Name:CRUZ
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:847-677-1400
Mailing Address - Street 1:9700 KENTON AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60076-1259
Mailing Address - Country:US
Mailing Address - Phone:847-677-1400
Mailing Address - Fax:847-933-3531
Practice Address - Street 1:9700 KENTON AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60076-1259
Practice Address - Country:US
Practice Address - Phone:847-677-1400
Practice Address - Fax:847-933-3531
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service