Individual provider Active NPI

Leslie Ann Bush, PA-C

  • Physician Assistant
  • Chicago, IL
National Provider Identifier
1194132746
Registry record updated Jul 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085005060 Issued in IL
Practice address
675 N Saint Clair St Ste 20-100
Chicago, IL 60611-5970
Phone
(312) 695-1920
Fax
(312) 695-5747
NPI assigned
Jul 15, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085005060 IL Primary

Addresses

Primary practice location

675 N Saint Clair St Ste 20-100
Chicago, IL 60611-5970

Mailing address

675 N Saint Clair St Ste 20-100
Chicago, IL 60611-5970
Phone (312) 695-1920

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150806011749 IL Practitioner - Physician Assistant 0648584490 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Northwestern Medical Faculty FoundationGroup PAC ID 4587576814, 4,386 clinicians

Practice addresses (Care Compare)

675 N Saint Clair St
Chicago, IL 60611-5975

675 N St Clair
Chicago, IL 60611-5975

Hospital & facility affiliations

  • Northwestern Memorial Hospital Hospital, Chicago, IL, CCN 140281

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
085005060ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Rush University Medical Center CurrentSince Oct 1, 2020 Accepting new patients
Rush University Medical Group CurrentSince Oct 1, 2020 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Mar 4, 2024 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Mar 4, 2024 Accepting new patients
Central Dupage Physician Group Past Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

675 N Saint Clair St
Ste 21-100
Chicago, IL 60611
Phone (312) 908-5284

1725 W Harrison St
Ste 809
Chicago, IL 60612
Phone (312) 942-5904

75 Remittance Dr
Dept 1611
Chicago, IL 60675

1700 W Van Buren St
#500
Chicago, IL 60612
Phone (312) 563-2875

675 N Saint Clair St
Ste 20-100
Chicago, IL 60611
Phone (312) 695-4360

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

Interoperability endpoints

  • Direct secure messaging: lbush51527@direct.rush.rush-health.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1405382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719878400000",
    "number": "1194132746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "675 N SAINT CLAIR ST STE 20-100",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606115970",
            "telephone_number": "312-695-1920",
            "fax_number": "312-695-5747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 N SAINT CLAIR ST STE 20-100",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606115970",
            "telephone_number": "312-695-1920",
            "fax_number": "312-695-5747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSH",
        "first_name": "LESLIE",
        "middle_name": "ANN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-15",
        "last_updated": "2024-07-02",
        "certification_date": "2024-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085005060",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.