Organization
UNIVERSITY PHYSICAL MEDICINE AND REHABILITATION
Active
Organization
UNIVERSITY PHYSICAL MEDICINE AND REHABILITATION
Active
Parent organization
RUSH UNIVERSITY MEDICAL CENTER
Organization subpart
Yes
Provider details
NPI number
Legal business name
RUSH UNIVERSITY MEDICAL CENTER
Authorized official
JOSHU ELLIS (AUTHORIZED OFFICIAL)
(312) 563-2717
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
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01636260
BC
IL
Enumeration date
05/05/2006
Last updated
02/16/2011
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