Rush Presbyterian-St Lukes Med Ctr

NPI #1609956903 in Chicago, Illinois

Provider Information

NPI Number: 1609956903
Entity Type: Organization
Organization Name: Rush Presbyterian-St Lukes Med Ctr
Subpart: Yes (part of a larger organization)
Parent Organization: RUSH UNIVERSITY MEDICAL CENTER
Primary Specialty: Clinic/Center - Oral and Maxillofacial Surgery
Enumeration Date: Oct 17, 2006
Last Updated: Oct 18, 2010

Practice Location

Address: 1725 W HARRISON ST
Address 2: SUITE 425, POB 1
City: Chicago
State: Illinois
ZIP Code: 60612-3841
Phone: (312) 563-3000

Authorized Official

Name: JOHN W. POLLEY
Title: MANAGER
Phone: (312) 563-3000

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Oral and Maxillofacial Surgery — Oral and Maxillofacial Surgery	261QS0112X	Primary

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