Healthcare Provider Details

I. General information

NPI: 1578478962
Provider Name (Legal Business Name): ADVENTIST BOLINGBROOK HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2026
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15720 S ROUTE 59 STE 200
PLAINFIELD IL
60544-2693
US

IV. Provider business mailing address

15720 S ROUTE 59 STE 200
PLAINFIELD IL
60544-2693
US

V. Phone/Fax

Practice location:
  • Phone: 630-312-3301
  • Fax:
Mailing address:
  • Phone: 630-312-3301
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: TRISTAN SHAW
Title or Position: CFO
Credential:
Phone: 630-312-6020