Individual
DR. DARRELL RUST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2701 17TH ST, ROCK ISLAND, IL 61201-5351
(309) 779-5000
Mailing address
2701 17TH ST, ROCK ISLAND, IL 61201-5351
(309) 779-5000
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
036069017
IL
207P00000X
Emergency Medicine Physician
336.033013
IL
2083A0300X
Addiction Medicine (Preventive Medicine) Physician
Primary
036.069017
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036069017001
TRICARE
—
05
—
036069017001
—
IL
01
—
93211
BCWELLMARK WEST
—
01
—
93234
BCWELLMARK 7TH
—
01
—
IL0181
JOHN DEERE
—
01
—
P00287227
RR MEDICARE
—
Enumeration date
02/09/2006
Last updated
02/12/2024
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