Individual provider Active NPI

Allana Kathleen Bush, NP-C, RN

  • Nurse Practitioner
  • Lake Forest, IL
National Provider Identifier
1972189975
Registry record updated Jan 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
277.003740 Issued in IL
Practice address
1025 W Everett Rd Ste 2
Lake Forest, IL 60045-2668
Phone
(224) 436-8006
Fax
(815) 331-1257
NPI assigned
Mar 20, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 2, 2026

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

Specialties & licenses 10

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 277.003740 IL Primary
Family Nurse Practitioner 363LF0000X AP61154896 WA
Family Nurse Practitioner 363LF0000X 14329-33 WI
Registered Nurse 163W00000X 95022797 CA
Family Nurse Practitioner 363LF0000X 202102459NP-PP OR
Registered Nurse 163W00000X 041.543152 IL
Registered Nurse 163W00000X RN61154884 WA
Registered Nurse 163W00000X 201705327RN OR
Family Nurse Practitioner 363LF0000X 95016976 CA
Registered Nurse 163W00000X 1106418-30 WI

Addresses

Primary practice location

1025 W Everett Rd Ste 2
Lake Forest, IL 60045-2668

Mailing address

1025 W Everett Rd Ste 2
Lake Forest, IL 60045-2668
Phone (224) 436-8006

Other practice location 1

5189 Hospital Rd
Mariposa, CA 95338-9524
Phone (209) 966-3631

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20220131000776 CA Practitioner - Nurse Practitioner 5193118917 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
041.543152ILMDRegistered Nurse
201705327RNORMDRegistered Nurse
RN61154884WAMDRegistered Nurse
1106418-30WIMDRegistered Nurse
277.003740ILMDNurse Practitioner
202102459NP-PPORMDFamily Nurse Practitioner
AP61154896WAMDFamily Nurse Practitioner
14329-33WIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Camarena Health Family Current Accepting new patients
Camarena Health CurrentSince Oct 20, 2021 Accepting new patients
John C Fremont Healthcare District CurrentSince Jul 23, 2023 Accepting new patients
Lake Forest Regenesis Medical Center, PLLC CurrentSince Oct 12, 2025 Accepting new patients
John C Fremont Healthcare District CurrentSince Jul 23, 2023 Accepting new patients
John C Fremont Healthcare District Current Accepting new patients
Camarena Health CurrentSince Oct 20, 2021 Accepting new patients

Locations

5186 Hospital Rd
Mariposa, CA 95338
Phone (209) 966-0850

5189 Hospital Rd
Mariposa, CA 95338
Phone (209) 966-3631

49169 Road 426
Oakhurst, CA 93644
Phone (559) 642-6724

1025 W Everett Rd
Ste 2
Lake Forest, IL 60045
Phone (224) 436-8006

Interoperability endpoints

  • FHIR API: https://fhir-usa.unify.chbase.com/org/fremont-d0489e1b

Organizations & group practices 7

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": "1616198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767312000000",
    "number": "1972189975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 W EVERETT RD STE 2",
            "city": "LAKE FOREST",
            "state": "IL",
            "postal_code": "600452668",
            "telephone_number": "224-436-8006",
            "fax_number": "815-331-1257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 W EVERETT RD STE 2",
            "city": "LAKE FOREST",
            "state": "IL",
            "postal_code": "600452668",
            "telephone_number": "224-436-8006",
            "fax_number": "815-331-1257"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5189 Hospital Rd",
            "address_purpose": "LOCATION",
            "city": "Mariposa",
            "state": "CA",
            "postal_code": "953389524",
            "country_code": "US",
            "telephone_number": "209-966-3631",
            "fax_number": "209-846-2043",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUSH",
        "first_name": "ALLANA",
        "middle_name": "KATHLEEN",
        "name_prefix": "Mrs.",
        "credential": "NP-C, RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-20",
        "last_updated": "2026-01-02",
        "certification_date": "2026-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "277.003740",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP61154896",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "14329-33",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95022797",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "202102459NP-PP",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041.543152",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN61154884",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OR",
            "license": "201705327RN",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95016976",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "1106418-30",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Forest, IL

Sources for this page

Verify at the official NPI Registry.