Organization
RUSH UNIVERSITY MEDICAL CENTER
Active
Parent organization
RUSH UNIVERSITY MEDICAL CENTER
Other names
Rush University Critical Care Specialist
Organization subpart
Yes
Provider details
NPI number
Legal business name
RUSH UNIVERSITY MEDICAL CENTER
Authorized official
ROBERT BALK M.D. (AUTHORIZED OFFICIAL)
(312) 942-5871
Entity
Organization
Contact information
Practice address
1725 W HARRISON ST, POB 054, CHICAGO, IL 60612-3841
(312) 942-5871
Mailing address
1725 W HARRISON ST, POB 054, CHICAGO, IL 60612-3841
(312) 942-5871
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
—
—
207RP1001X
Pulmonary Disease Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01630341
BC GROUP
IL
Enumeration date
05/18/2006
Last updated
11/09/2007
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