# LAKE FOREST REGENESIS MEDICAL CENTER, PLLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1871308999
- **Authorized official:** MRS. ALLANA KATHLEEN BUSH FNP-C (FNP-C)
- **Authorized official phone:** (224) 436-8006

## Contact information

- **Practice address:** 1025 W EVERETT RD STE 2, LAKE FOREST, IL 60045-2668
- **Practice address phone:** (224) 436-8006
- **Practice address fax:** (949) 703-8371
- **Mailing address:** 1025 W EVERETT RD STE 2, LAKE FOREST, IL 60045-2668
- **Mailing address phone:** (224) 436-8006
- **Mailing address fax:** (949) 703-8371

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 02/07/2025
- **Last updated:** 02/07/2025