Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0300X | Geriatric Medicine | 36-058235 | IL |
NPI | 1154459840 |
---|---|
Provider Name | Dr. Patricia Anne Rush |
First Address | Chicago, IL 60649-2503 |
Second Address | Chicago, IL 60649-2503 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/03/2007 |
Last Update Date | 30/07/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E24375 | (02) |