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General NPI Number Information
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NPI Number | 1760620819
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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 | 01/28/2009
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Last Update Date | 06/21/2018
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Provider Practice Location Address
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Address Line | 396 REMINGTON BLVD SUITE 310
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City | BOLINGBROOK
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State | IL
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Zip | 60440-4920
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Country | US
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Telephone | 630-226-1436
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Fax | 630-226-6938
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Provider Business Mailing Address
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Address Line | 396 REMINGTON BLVD STE 310
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City | BOLINGBROOK
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State | IL
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Zip | 60440-4302
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Country | US
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Telephone | 630-226-1436
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Fax | 630-226-6938
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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 | 208800000X
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Taxonomy Name | Urology Physician
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License Number |
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License Number State |
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