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Individual
JOHN G BUSH JR.
Active
Individual
JOHN G BUSH JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207VX0000X
Obstetrics Physician
Primary
036.133513
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P01242540
TRICARE
IL
Enumeration date
04/07/2009
Last updated
12/28/2021
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