Basic Information
| Provider Information | |||||||||
| NPI: | 1346455094 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BUSSING | ||||||||
| FirstName: | DANA | ||||||||
| MiddleName: | COLLINS | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 401 N MICHIGAN AVENUE | ||||||||
| Address2: | SUITE 1200 | ||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606114264 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3126350973 | ||||||||
| FaxNumber: | 8132909691 | ||||||||
| Practice Location | |||||||||
| Address1: | 512 E OGDEN AVE | ||||||||
| Address2: | |||||||||
| City: | WESTMONT | ||||||||
| State: | IL | ||||||||
| PostalCode: | 605591228 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6303234400 | ||||||||
| FaxNumber: | 6303234583 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/14/2007 | ||||||||
| LastUpdateDate: | 10/30/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208100000X | 036129143 | IL | Y | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation |
ID Information
| ID | Type | State | Issuer | Description | 036129143 | 01 | IL | LICENSE | OTHER | P01116314, P01116314 | 01 | IL | RAILROAD MEDICARE | OTHER | 036129143 | 05 | IL | MEDICAID |