RUSH PRESBYTERIAN-ST LUKES MED CTR NPI 1609956903

NPI Information

RUSH PRESBYTERIAN-ST LUKES MED CTR is an oral and maxillofacial surgery clinic center in Chicago, IL. The provider is the specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. RUSH PRESBYTERIAN-ST LUKES MED CTR NPI is 1609956903. The provider is registered as an organization entity type.
The provider Is Doing Business As Rush Craniofacial Center.

The provider's business location address is:

1725 W HARRISON ST
SUITE 425, POB 1
CHICAGO, IL
ZIP 60612-841
Phone: (312) 563-3000
Fax: (312) 563-2514

The provider's authorized official is John W. Polley .
The authorized official title is Manager and has the following contact phone number (312) 563-3000.

The enumeration date for this NPI number is 10/17/2006 and was last updated on 10/18/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

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