# COLLEGE OF NURSING FACULTY PRACTICE

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** RUSH UNIVERSITY MEDICAL CENTER
- **Other names:** RUSH ADOLESCENT FAMILY CENTER
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1588010276
- **Legal business name:** RUSH UNIVERSITY MEDICAL CENTER
- **Authorized official:** STEPHEN GILLENWATER (PROGRAM MANAGER)
- **Authorized official phone:** (312) 942-2859

## Contact information

- **Practice address:** 1645 W JACKSON BLVD, SUITE 315, CHICAGO, IL 60612-3276
- **Practice address phone:** (312) 942-2777
- **Practice address fax:** (312) 942-2822
- **Mailing address:** 1645 W JACKSON BLVD, SUITE 315, CHICAGO, IL 60612-3276
- **Mailing address phone:** (312) 942-2777
- **Mailing address fax:** (312) 942-2822

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA0005X | Ambulatory Family Planning Facility | — | IL | Yes |

## Other

- **Enumeration date:** 05/11/2016
- **Last updated:** 05/11/2016