Organization
UNIVERSITY NEUROSURGERY
Active
Parent organization
RUSH UNIVERSITY MEDICAL CENTER
Organization subpart
Yes
Provider details
NPI number
Legal business name
RUSH UNIVERSITY MEDICAL CENTER
Authorized official
JOSHUA ELLIS (AUTHORIZED OFFICIAL)
(312) 942-6644
Entity
Organization
Contact information
Practice address
1725 W HARRISON ST, SUITE 970, CHICAGO, IL 60612-3841
(312) 942-6644
Mailing address
1725 W HARRISON ST, SUITE 970, CHICAGO, IL 60612-3841
(312) 942-6644
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01636195
BC PPO
IL
01
—
DE6284
RR MCR
IL
Enumeration date
05/05/2006
Last updated
05/03/2011
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