Organization
COLLEGE OF NURSING FACULTY PRACTICE
Active
Parent organization
RUSH UNIVERSITY MEDICAL CENTER
Other names
RUSH ADOLESCENT FAMILY CENTER
Organization subpart
Yes
Provider details
NPI number
Legal business name
RUSH UNIVERSITY MEDICAL CENTER
Authorized official
STEPHEN GILLENWATER (PROGRAM MANAGER)
(312) 942-2859
Entity
Organization
Contact information
Practice address
1645 W JACKSON BLVD, SUITE 315, CHICAGO, IL 60612-3276
(312) 942-2777
(312) 942-2822
Mailing address
1645 W JACKSON BLVD, SUITE 315, CHICAGO, IL 60612-3276
(312) 942-2777
(312) 942-2822
Taxonomy
Speciality
Code
Description
License number
State
261QA0005X
Ambulatory Family Planning Facility
Primary
—
IL
Other
Enumeration date
05/11/2016
Last updated
05/11/2016
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