Organization Active NPI

John G. Bush, DO LTD

  • Obstetrics & Gynecology Physician
  • Frankfort, IL
National Provider Identifier
1679775423
Registry record updated Nov 25, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
03654141 Issued in IL
Legal business name
JOHN G. BUSH, DO LTD
Practice address
222 Colorado Ave.
Frankfort, IL 60423-1334
Phone
(815) 469-6646
Fax
(815) 469-6647
NPI assigned
Jun 4, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2009

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

Authorized official

Name
Dr. John Gregory Bush, DONPI 1952332165
Title
President
Phone
(815) 469-6646

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X 03654141 IL Primary
Hospice and Palliative Medicine (Obstetrics & Gynecology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207VH0002X 036-054141 IL

Addresses

Primary practice location

222 Colorado Ave.
Frankfort, IL 60423-1334

Mailing address

222 Colorado Ave.
Frankfort, IL 60423-1334
Phone (815) 469-6646

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091210000069 IL Part B Supplier - Clinic/Group Practice 0840339537 Receives reassigned benefits from 3 practitioners
Practice locations: Frankfort, IL; New Lenox, IL

National Provider Directory

National Provider Directory

Locations

1890 Silver Cross Blvd
Ste 420
New Lenox, IL 60451
Phone (815) 320-3520

9661 W 143rd St
Ste 102
Orland Park, IL 60462
Phone (708) 460-0931

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1180915200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1259107200000",
    "number": "1679775423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 COLORADO AVE.",
            "city": "FRANKFORT",
            "state": "IL",
            "postal_code": "604231334",
            "telephone_number": "815-469-6646",
            "fax_number": "815-469-6647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 COLORADO AVE.",
            "city": "FRANKFORT",
            "state": "IL",
            "postal_code": "604231334",
            "telephone_number": "815-469-6646",
            "fax_number": "815-469-6647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN G. BUSH, DO LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-04",
        "last_updated": "2009-11-25",
        "status": "A",
        "authorized_official_last_name": "BUSH",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "GREGORY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "815-469-6646",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "03654141",
            "primary": true
        },
        {
            "code": "207VH0002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology, Hospice and Palliative Medicine",
            "state": "IL",
            "license": "036-054141",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frankfort, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.