Healthcare Provider Details

I. General information

NPI: 1871739177
Provider Name (Legal Business Name): ADVENTIST HEALTH PARTNERS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/17/2008
Last Update Date: 06/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15728 S RTE 59
PLAINFIELD IL
60544-2693
US

IV. Provider business mailing address

15728 S ROUTE 59
PLAINFIELD IL
60544-2693
US

V. Phone/Fax

Practice location:
  • Phone: 815-436-8831
  • Fax: 815-436-6863
Mailing address:
  • Phone: 815-436-8831
  • Fax: 815-436-6863

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

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