Individual
JOHN G BUSH JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
350 S NORTHWEST HWY STE 112, PARK RIDGE, IL 60068-4262
(847) 825-8108
(847) 825-1774
Mailing address
2801 LAKESIDE DR, STE 209, BANNOCKBURN, IL 60015-1271
(847) 562-1410
(847) 562-0830
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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