Healthcare Provider Details
I. General information
NPI: 1861307555
Provider Name (Legal Business Name): EDWARD HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
24600 W 127TH ST
PLAINFIELD IL
60585-9507
US
IV. Provider business mailing address
801 S WASHINGTON ST
NAPERVILLE IL
60540-7430
US
V. Phone/Fax
- Phone: 630-527-3000
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 291U00000X |
| Taxonomy | Clinical Medical Laboratory |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SHAUN
WALDER
Title or Position: SYSTEM VP PFS
Credential:
Phone: 630-646-3702