Individual
JOHN BUSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
3990 N ILLINOIS ST, SWANSEA, IL 62226-1919
(618) 277-1130
(618) 277-4917
Mailing address
3990 N ILLINOIS ST, SWANSEA, IL 62226-1919
(618) 277-1130
(618) 277-4917
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046008176
IL
Other
Enumeration date
08/31/2006
Last updated
07/08/2007
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