Healthcare Provider Details

I. General information

NPI: 1760736714
Provider Name (Legal Business Name): ADVENTIST HEALTH PARTNERS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/30/2012
Last Update Date: 06/14/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

950 N YORK RD STE 109
HINSDALE IL
60521-2950
US

IV. Provider business mailing address

950 N YORK RD STE 109
HINSDALE IL
60521-2950
US

V. Phone/Fax

Practice location:
  • Phone: 630-654-1391
  • Fax: 630-654-1967
Mailing address:
  • Phone: 630-654-1391
  • Fax: 630-654-1967

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207YS0123X
TaxonomyFacial Plastic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. RUBY MANN
Title or Position: DIRECTOR
Credential:
Phone: 630-856-6884