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General NPI Number Information
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NPI Number | 1588978670
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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 | 07/30/2010
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Last Update Date | 06/14/2017
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Provider Practice Location Address
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Address Line | 5201 WILLOW SPRINGS RD STE 160
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City | LA GRANGE
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State | IL
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Zip | 60525-6537
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Country | US
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Telephone | 708-354-0920
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Fax | 708-354-0974
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Provider Business Mailing Address
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Address Line | 5201 S. WILLOW SPRINGS RD STE 160
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City | LAGRANGE
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State | IL
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Zip | 60525
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Country | US
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Telephone | 708-354-0920
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Fax | 708-354-0974
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Authorized Official
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Title or Position | DIRECTOR
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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