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Organization

RUSH UNIVERSITY MEDICAL CENTER

Active
Parent organization
RUSH UNIVERSITY MEDICAL CENTER
Other names
Rush Alzheimers Disease Center
Organization subpart
Yes

Provider details

NPI number
Legal business name
RUSH UNIVERSITY MEDICAL CENTER
Authorized official
RAJ C SHAH M.D. (AUTHORIZED OFFICIAL)
(312) 563-2902
Entity
Organization

Contact information

Practice address
600 S PAULINA ST, SUITE 130, CHICAGO, IL 60612-3806
(312) 942-3333
(312) 942-4154
Mailing address
600 S PAULINA ST, SUITE 130, CHICAGO, IL 60612-3806
(312) 942-3333
(312) 942-4154

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
363L00000X
Nurse Practitioner

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01617418
BC GROUP
IL
Enumeration date
03/02/2007
Last updated
03/17/2008
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