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General NPI Number Information
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NPI Number | 1366487936
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Entity Type | Organization
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Legal Business Name | ADVENTIST HEALTH PARTNERS, INC
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Dates
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Enumeration Date | 06/18/2006
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Last Update Date | 06/12/2017
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Provider Practice Location Address
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Address Line | 6438 JOLIET RD
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City | COUNTRYSIDE
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State | IL
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Zip | 60525-4685
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Country | US
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Telephone | 708-352-5222
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Fax | 708-352-5285
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Provider Business Mailing Address
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Address Line | 6438 JOLIET RD
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City | COUNTRYSIDE
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State | IL
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Zip | 60525-4685
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Country | US
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Telephone | 708-352-5222
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Fax | 708-352-5285
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Authorized Official
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Title or Position | DIRECTOR OF MANAGED CARE
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Name | MRS. RUBY MANN
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Credential |
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Telephone | 630-856-6884
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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