1821212937 NPI number — RUSH UNIVERSITY &MEDICAL CENTER

Table of content: DR. NATALIE DORIN PUTMAN MD (NPI 1427851161)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821212937 NPI number — RUSH UNIVERSITY &MEDICAL CENTER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RUSH UNIVERSITY &MEDICAL CENTER
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1821212937
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8536 S BENNETT AVE
Provider Second Line Business Mailing Address:
3 FLR
Provider Business Mailing Address City Name:
CHICAGO
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60617-2255
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
773-734-4353
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1653 W CONGRESS PKWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHICAGO
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60612-3833
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
321-942-6574
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/12/2007

Additional Information

Authorized Official

Authorized Official Last Name:
BRADLEY
Authorized Official First Name:
DEBORAH
Authorized Official Middle Name:
ANN
Authorized Official Title or Position:
OCCUPATIONAL THERAPY ASSISTANT
Authorized Official Telephone Number:
312-942-6574

Provider Taxonomy Codes

  • Taxonomy code: 282N00000X , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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