Individual provider Active NPI

Gameli Dekayie Bush, MD

  • Emergency Medicine Physician
  • Hazel Crest, IL
National Provider Identifier
1306159363
Registry record updated Apr 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
036.132346 Issued in IL
Practice address
17800 Kedzie Ave
Hazel Crest, IL 60429-2029
Phone
(708) 213-4200
Fax
(708) 213-0144
NPI assigned
Jul 20, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 036.132346 IL Primary

Addresses

Primary practice location

17800 Kedzie Ave
Hazel Crest, IL 60429-2029

Mailing address

29373 Network PL
Chicago, IL 60673-1945
Phone (847) 390-5900

Other names 1

  • Gameli Adzo Dekayie-Amenu Former name

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address gdekayie205869@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
I20130712000559 IL Practitioner - Emergency Medicine 4284874348 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.132346ILMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emerge Medstaffing LLC CurrentSince Jun 10, 2019 Accepting new patients
Advocate Health and Hospitals Corporation Current Accepting new patients
Em Strategies,LTD. Emergency Medicine CurrentSince Mar 18, 2024 Accepting new patients
Emerge Medstaffing LLC Emergency Medicine CurrentSince Jun 10, 2019 Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Jul 15, 2013 Accepting new patients
Advocate Health & Hospitals Corp. Emergency Medicine CurrentSince Jul 15, 2013 Accepting new patients

Locations

595 William R Latham SR Dr
Bourbonnais, IL 60914
Phone (815) 932-8944

135 N Arlington Heights Rd
Buffalo Grove, IL 60089
Phone (847) 215-8866

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

29373 Network Pl
Chicago, IL 60673

30 E 15th St
Chicago Hts, IL 60411
Phone (312) 206-1064

20180 S Lagrange Rd
Frankfort, IL 60423
Phone (630) 362-1035

17800 Kedzie Ave
Hazel Crest, IL 60429
Phone (708) 213-4200

12701 W 143rd St
Lockport, IL 60491
Phone (708) 364-6337

1900 Silver Cross Blvd
New Lenox, IL 60451
Phone (815) 300-7106

Interoperability endpoints

  • Direct secure messaging: gdekayie205869@direct.myadvocateaurora.org

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1279584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713312000000",
    "number": "1306159363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29373 NETWORK PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606731945",
            "telephone_number": "847-390-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17800 KEDZIE AVE",
            "city": "HAZEL CREST",
            "state": "IL",
            "postal_code": "604292029",
            "telephone_number": "708-213-4200",
            "fax_number": "708-213-0144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSH",
        "first_name": "GAMELI",
        "middle_name": "DEKAYIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-20",
        "last_updated": "2024-04-17",
        "certification_date": "2024-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036.132346",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gdekayie205869@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "17800 Kedzie Ave",
            "city": "Hazel Crest",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604292029",
            "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": "17800 Kedzie Ave",
            "city": "Hazel Crest",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604292029",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "GAMELI",
            "last_name": "DEKAYIE-AMENU",
            "middle_name": "ADZO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Hazel Crest, IL

Sources for this page

Verify at the official NPI Registry.