Organization
RUSH OTOLARYNGOLOGY HEAD AND NECK SURGERY
Active
Parent organization
RUSH UNIVERSITY MEDICAL CENTER
Organization subpart
Yes
Provider details
NPI number
Legal business name
RUSH UNIVERSITY MEDICAL CENTER
Authorized official
DAVID D CALDARELLI M.D. (AUTHORIZED OFFICIAL)
(312) 942-6100
Entity
Organization
Contact information
Practice address
1611 W HARRISON ST, SUITE 550, CHICAGO, IL 60612-4861
(312) 942-6100
(312) 942-6225
Mailing address
1611 W HARRISON ST, SUITE 550, CHICAGO, IL 60612-4861
(312) 942-6100
(312) 942-6225
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01636656
BC PPO
IL
Enumeration date
10/21/2006
Last updated
06/23/2010
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