Healthcare Provider Details

I. General information

NPI: 1407889652
Provider Name (Legal Business Name): ADVENTIST MIDWEST HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2006
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5101 WILLOW SPRINGS RD
LA GRANGE IL
60525-2600
US

IV. Provider business mailing address

5101 WILLOW SPRINGS RD
LA GRANGE IL
60525-2600
US

V. Phone/Fax

Practice location:
  • Phone: 708-352-1200
  • Fax: 630-312-7975
Mailing address:
  • Phone: 708-352-1200
  • Fax: 630-312-7975

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number0005017
License Number StateIL

VIII. Authorized Official

Name: CULLY CHAPMAN
Title or Position: CFO
Credential:
Phone: 630-856-6006