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General NPI Number Information
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NPI Number | 1053415653
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Entity Type | Organization
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Legal Business Name | ADVENTIST MIDWEST HEALTH
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Dates
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Enumeration Date | 09/12/2006
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Last Update Date | 11/12/2024
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Provider Practice Location Address
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Address Line | 120 NORTH OAK STREET
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City | HINSDALE
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State | IL
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Zip | 60521-3829
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Country | US
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Telephone | 630-856-3966
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Fax | 630-856-3939
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Provider Business Mailing Address
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Address Line | 120 NORTH OAK STREET
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City | HINSDALE
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State | IL
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Zip | 60521-3829
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Country | US
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Telephone | 630-856-3966
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Fax | 630-856-3939
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Authorized Official
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Title or Position | DIRECTOR REIMBURSEMENT
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Name | CHRISTINE THOMAS
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Credential |
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Telephone | 407-357-2315
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 093002925
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License Number State | IL
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