NPIMap

Organization Active NPI

Rush Presbyterian St. Lukes Medical Center

  • Internal Medicine Physician
  • Oak Park, IL
National Provider Identifier
1154370005
Registry record updated Jan 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
RUSH PRESBYTERIAN ST. LUKES MEDICAL CENTER
Practice address
610 S Maple Ave
Suite 3900
Oak Park, IL 60304-1091
Phone
(708) 524-1674
NPI assigned
May 9, 2006
Organization subpart
Yes
Parent organization
RUSH PRESBYTERIAN ST. LUKES MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 23, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Theresa M Dabek, M.D.
Title
Authorized Official
Phone
(708) 524-1674

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207Q00000X
Internal Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207R00000X Primary
Pediatrics PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208000000X

Addresses

Primary practice location

610 S Maple Ave
Suite 3900
Oak Park, IL 60304-1091

Mailing address

610 S Maple Ave
Suite 3900
Oak Park, IL 60304-1091
Phone (708) 524-1674

Other identifiers 1

IdentifierTypeStateIssuer
01623486OtherILBC GROUP

Other names 1

  • Anchor Oak Park Medical Doing business as

National Provider Directory

National Provider Directory
Part of
University Anesthesiologists SC

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

1049 Lake St
Oak Park, IL 60301
Phone (312) 876-4577

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 17

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1232668800000",
    "number": "1154370005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 S MAPLE AVE",
            "address_2": "SUITE 3900",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603041091",
            "telephone_number": "708-524-1674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 S MAPLE AVE",
            "address_2": "SUITE 3900",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603041091",
            "telephone_number": "708-524-1674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUSH PRESBYTERIAN ST. LUKES MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RUSH PRESBYTERIAN ST. LUKES MEDICAL CENTER",
        "enumeration_date": "2006-05-09",
        "last_updated": "2009-01-23",
        "status": "A",
        "authorized_official_last_name": "DABEK",
        "authorized_official_first_name": "THERESA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "708-524-1674",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC GROUP",
            "identifier": "01623486",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Anchor Oak Park Medical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oak Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.