Bush-Joseph, Charles A

Bush-Joseph, Charles A is an individual health care provider with primary practice located at 1611 W Harrison St Ste 400 , Chicago IL 60612-4861. He recently has only one registered license in Allopathic & Osteopathic Physicians / Sports Medicine, which is considered as his primary health care specialty. Bush-Joseph, Charles A can be contacted via phone (877) 632-6637.

Contact Information

Primary practice address
1611 W Harrison St Ste 400 Chicago IL 60612-4861
Phone: (877) 632-6637
Fax: (708) 409-5179
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Sports Medicine 207XX0005X 01079047A Indiana
Allopathic & Osteopathic Physicians / Sports Medicine 207XX0005X 036070386 Illinois

Profile Details

NPI number 1821077736
LBN Legal business name Bush-Joseph, Charles A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 10th, 2006
Last updated Sep 18th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1821077736 NPPES
Other 4120999 AETNA
Other 207073 AETNA
Other 207067 AETNA
Other P00202615 AETNA
Other DA4902 AETNA

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