Organization
RUSH UNIVERSITY MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JASON SHIPBAUGH PT, DPT (PHYSICAL THERAPIST)
(630) 726-0003
Entity
Organization
Contact information
Practice address
4536 N GREENVIEW AVE APT 2N, CHICAGO, IL 60640-5475
(630) 726-0003
Mailing address
4536 N GREENVIEW AVE APT 2N, CHICAGO, IL 60640-5475
(630) 726-0003
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
070.021807
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
070.021807
STATE OF ILINOIS
IL
Enumeration date
01/19/2016
Last updated
01/19/2016
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