Provider Demographics
NPI:1295119808
Name:ADVOCATE CHRIST MEDICAL CENTER
Entity type:Organization
Organization Name:ADVOCATE CHRIST MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:APN- EMERGENCY SERVICES
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:RUSCO
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-BC
Authorized Official - Phone:708-903-3974
Mailing Address - Street 1:12997 SUNRISE DR
Mailing Address - Street 2:
Mailing Address - City:LEMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60439-4565
Mailing Address - Country:US
Mailing Address - Phone:708-903-3974
Mailing Address - Fax:
Practice Address - Street 1:12997 SUNRISE DR
Practice Address - Street 2:
Practice Address - City:LEMONT
Practice Address - State:IL
Practice Address - Zip Code:60439-4565
Practice Address - Country:US
Practice Address - Phone:708-903-3974
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-13
Last Update Date:2015-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209012912261QE0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0002XAmbulatory Health Care FacilitiesClinic/CenterEmergency Care