NPIMap

Organization Active NPI

Rush Adolescent Family Center

  • Ambulatory Family Planning Facility
  • Chicago, IL
National Provider Identifier
1902922115
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Family Planning FacilityTaxonomy code 261QA0005X
Legal business name
RUSH ADOLESCENT FAMILY CENTER
Practice address
1645 W Jackson Blvd Ste 315
Chicago, IL 60612-3227
Phone
(312) 942-2777
Fax
(312) 942-2822
NPI assigned
Mar 21, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Stephen GillenwaterNPI 1265909600
Title
Program Manager
Phone
(312) 942-2859

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Family Planning Facility 261QA0005X IL Primary

Addresses

Primary practice location

1645 W Jackson Blvd Ste 315
Chicago, IL 60612-3227

Mailing address

1645 W Jackson Blvd Ste 315
Chicago, IL 60612-3227
Phone (312) 942-2777

National Provider Directory

National Provider Directory
Tax ID family
Invalid Entry19 organizations share this tax ID, including this one

Other organizations with this tax ID 18

Organizations that report the same tax identification number in the National Provider Directory.

View all 18

Locations

1645 W Jackson Blvd
Ste 315
Chicago, IL 60612
Phone (312) 942-2777

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1902922115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1645 W JACKSON BLVD STE 315",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123227",
            "telephone_number": "312-942-2777",
            "fax_number": "312-942-2822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1645 W JACKSON BLVD STE 315",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123227",
            "telephone_number": "312-942-2777",
            "fax_number": "312-942-2822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUSH ADOLESCENT FAMILY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GILLENWATER",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_title_or_position": "PROGRAM MANAGER",
        "authorized_official_telephone_number": "312-942-2859",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QA0005X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Family Planning Facility",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.