Active NPI
Charles A Bush-Joseph, M.D.
- Sports Medicine (Orthopaedic Surgery) Physician
- Chicago, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Medicine (Orthopaedic Surgery) Physician
- License
- 036070386
- Practice address
- 1611 W Harrison St Ste 400
Chicago, IL 60612-4861 - Phone
- (877) 632-6637
- Fax
- (708) 409-5179
- NPI assigned
- Jan 10, 2006
- Last updated
- Sep 18, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sports Medicine (Orthopaedic Surgery) Physician | 207XX0005X | 01079047A | IN | |
| Sports Medicine (Orthopaedic Surgery) Physician | 207XX0005X | 036070386 | IL | Primary |
Addresses
Primary practice location
1611 W Harrison St Ste 400
Chicago, IL 60612-4861
Mailing address
1611 W Harrison St Ste 400
Chicago, IL 60612-4861
Phone (877) 632-6637
Other practice location 1
9200 Calumet Ave Ste 300
Munster, IN 46321-2885
Phone (877) 632-6637
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4120999 | Other | AETNA | |
| DA4902 | Other | RAILROAD MEDICARE PTAN | |
| 207067 | Other | IL | MEDICARE PTAN LOCALITY 16 |
| 207073 | Other | IL | MEDICARE PTAN LOCALITY 15 |
| P00202615 | Other | RAILROAD MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL, IN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Sports Medicine
- Education
- Michigan State University College of Human Medicine, 1983
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1611 W Harrison St
Suite 400
Chicago, IL 60612-4861
Phone (877) 632-6637
9601 Calumet Ave
Munster, IN 46321-2871
Phone (877) 632-6637
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Lower limb (leg) arthroscopy (minimally invasive joint repair) | 1-10 |
| Upper limb (arm) arthroscopy (minimally invasive joint repair) | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036070386 | IL | MD | Sports Medicine (Orthopaedic Surgery) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Orthomidwest, PLLC | Current | Accepting new patients | |
| Midwest Orthopaedics at Rush LLC | Current | Accepting new patients | |
| Orthomidwest, PLLC | Sports Medicine | Current | Accepting new patients |
| Midwest Orthopaedics at Rush, LLC | Current | Accepting new patients | |
| Gibson Community Hospital Association | Past | Accepting new patients |
Locations
770 Beloit Rd
Belvidere, IL 61008
Phone (815) 847-7060
1611 W Harrison St
#400
Chicago, IL 60612
Phone (312) 243-4244
1611 W Harrison St
Ste 107
Chicago, IL 60612
Phone (312) 432-2513
1611 W Harrison St
Ste 400
Chicago, IL 60612
Phone (312) 243-4244
963 N 129th Infantry Dr
Joliet, IL 60435
Phone (815) 725-8425
1 Westbrook Corporate Ctr
Ste 240
Westchester, IL 60154
9200 Calumet Ave
Munster, IN 46321
Phone (219) 664-9232
9200 Calumet Ave
#300
Munster, IN 46321
9200 Calumet Ave
Ste 300
Munster, IN 46321
Phone (708) 236-2737
9601 Calumet Ave
Munster, IN 46321
Phone (312) 432-2591
Interoperability endpoints
- charles.bush-joseph.1@12576.direct.athenahealth.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Durable Medical Equipment & Medical Supplies
- Orland Park, IL
- NPI 1134871908
-
- Durable Medical Equipment & Medical Supplies
- Buffalo Grove, IL
- NPI 1043180839
-
dba Gibson Area Hospital and Health Services
- Critical Access Hospital
- Gibson City, IL
- NPI 1114935681
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1136851200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1694995200000",
"number": "1821077736",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1611 W HARRISON ST STE 400",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606124861",
"telephone_number": "877-632-6637",
"fax_number": "708-409-5179"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1611 W HARRISON ST STE 400",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606124861",
"telephone_number": "877-632-6637",
"fax_number": "708-409-5179"
}
],
"practiceLocations": [
{
"address_1": "9200 Calumet Ave Ste 300",
"address_purpose": "LOCATION",
"city": "Munster",
"state": "IN",
"postal_code": "463212885",
"country_code": "US",
"telephone_number": "877-632-6637",
"fax_number": "708-409-5179",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BUSH-JOSEPH",
"first_name": "CHARLES",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-10",
"last_updated": "2023-09-18",
"certification_date": "2023-09-18",
"status": "A"
},
"taxonomies": [
{
"code": "207XX0005X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery, Sports Medicine",
"state": "IN",
"license": "01079047A",
"primary": false
},
{
"code": "207XX0005X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery, Sports Medicine",
"state": "IL",
"license": "036070386",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4120999",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE PTAN",
"identifier": "DA4902",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN LOCALITY 16",
"identifier": "207067",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN LOCALITY 15",
"identifier": "207073",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00202615",
"state": null
}
],
"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 Sep 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.