Organization
RUSH PRESBYTERIAN ST. LUKES MEDICAL CENTER
Active
Parent organization
RUSH PRESBYTERIAN ST. LUKES MEDICAL CENTER
Other names
CCH Surgical Affiliates
Organization subpart
Yes
Provider details
NPI number
Legal business name
RUSH PRESBYTERIAN ST. LUKES MEDICAL CENTER
Authorized official
BRIAN T SMITH (AUTHORIZED OFFICIAL)
(312) 942-6909
Entity
Organization
Contact information
Practice address
1725 W HARRISON ST, SUITE 818, CHICAGO, IL 60612-3841
(312) 942-6511
Mailing address
1725 W HARRISON ST, SUITE 818, CHICAGO, IL 60612-3841
(312) 942-6511
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01623879
BC PPO
IL
Enumeration date
05/08/2006
Last updated
02/09/2011
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