Organization
DEPARTMENT OF BEHAVIORAL SCIENCES
Active
Parent organization
RUSH UNIVERSITY MEDICAL CENTER
Organization subpart
Yes
Provider details
NPI number
Legal business name
RUSH UNIVERSITY MEDICAL CENTER
Authorized official
BRIAN T SMITH (AUTHORIZED OFFICIAL)
(312) 942-6909
Entity
Organization
Contact information
Practice address
1645 W JACKSON BLVD, SUITE 400, CHICAGO, IL 60612-3276
(312) 942-5932
Mailing address
1645 W JACKSON BLVD, SUITE 400, CHICAGO, IL 60612-3276
(312) 942-5932
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
—
—
103T00000X
Psychologist
—
—
103TC0700X
Clinical Psychologist
Primary
—
—
2084S0012X
Sleep Medicine (Psychiatry & Neurology) Physician
—
—
Other
Enumeration date
06/03/2008
Last updated
07/22/2010
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