Individual provider Active NPI

Kylie Elizabeth Bussie, MD

  • Family Medicine Physician
  • Chicago, IL
National Provider Identifier
1225520216
Registry record updated Apr 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036.157332 Issued in IL
Practice address
1357 W 103Rd St
Chicago, IL 60643-2392
Phone
(773) 238-0800
NPI assigned
Jun 5, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 20, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036.157332 IL Primary

Addresses

Primary practice location

1357 W 103Rd St
Chicago, IL 60643-2392

Mailing address

1357 W 103Rd St
Chicago, IL 60643-2392
Phone (773) 238-0800

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address kbussie207567@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211018002353 IL Practitioner - Obstetrics/Gynecology 0446658710 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

11600 S Kedzie Ave
Merrionette Park, IL 60803-6307
Phone (708) 272-4150

1357 W 103Rd St
Adv Med GRP Evergreen
Chicago, IL 60643-2392
Phone (773) 238-0800

214 McHenry Rd
Buffalo Grove, IL 60089-6748
Phone (847) 459-1160

901 E 95TH St
Chicago, IL 60619-7826
Phone (312) 878-9240

9550 W 167TH St
Orland Park, IL 60467-5561

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036.157332ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advocate Health & Hospitals Corporation CurrentSince Oct 8, 2021 Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Oct 8, 2021 Accepting new patients
Advocate Health and Hospitals Corporation Current Accepting new patients

Locations

214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160

1357 W 103rd St
Chicago, IL 60643
Phone (773) 238-0800

29373 Network Pl
Chicago, IL 60673

4140 Southwest Hwy
Oak Lawn, IL 60456
Phone (708) 422-5700

Interoperability endpoints

  • Direct secure messaging: kbussie207567@direct.myadvocateaurora.org

Organizations & group practices 3

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 5

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": "1528156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650412800000",
    "number": "1225520216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1357 W 103RD ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606432392",
            "telephone_number": "773-238-0800",
            "fax_number": "738-817-2347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1357 W 103RD ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606432392",
            "telephone_number": "773-238-0800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSSIE",
        "first_name": "KYLIE",
        "middle_name": "ELIZABETH",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-05",
        "last_updated": "2022-04-20",
        "certification_date": "2022-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036.157332",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kbussie207567@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1357 W 103rd St",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606432392",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "1357 W 103rd St",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606432392",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.