Provider Demographics
NPI:1144846353
Name:EXPRESS CARE, LLC
Entity type:Organization
Organization Name:EXPRESS CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:NICHELLE
Authorized Official - Middle Name:M
Authorized Official - Last Name:BUSH
Authorized Official - Suffix:
Authorized Official - Credentials:MSN, APRN-FPA, FNP-C
Authorized Official - Phone:708-369-5753
Mailing Address - Street 1:11 E ADAMS ST STE 1100
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60603-6315
Mailing Address - Country:US
Mailing Address - Phone:312-360-9600
Mailing Address - Fax:
Practice Address - Street 1:11 E ADAMS ST STE 1100
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60603-6315
Practice Address - Country:US
Practice Address - Phone:312-360-9600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-23
Last Update Date:2020-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access