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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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