Provider Demographics
NPI:1720199011
Name:RUSH UNIVERSITY MEDICAL CENTER
Entity Type:Organization
Organization Name:RUSH UNIVERSITY MEDICAL CENTER
Other - Org Name:RUSH UNIVERSITY INTERNAL MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:PAULSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-942-7118
Mailing Address - Street 1:230 W MONROE ST
Mailing Address - Street 2:SUITE 1925
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60606-4703
Mailing Address - Country:US
Mailing Address - Phone:312-942-3100
Mailing Address - Fax:
Practice Address - Street 1:230 W MONROE ST
Practice Address - Street 2:SUITE 1925
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60606-4703
Practice Address - Country:US
Practice Address - Phone:312-942-3100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RUSH UNIVERSITY MEDICAL CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-08-31
Last Update Date:2008-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01622000OtherBC GROUP
IL01622000OtherBC GROUP