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NPI Code Detail

MEDICARE: ADVENTIST HEALTH PARTNERS,INC

MEDICARE: ADVENTIST HEALTH PARTNERS,INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RG0300XGeriatric Medicine (Internal Medicine) Physician

General Provider Information

NPI Number : 1679518765
Entity Type Code : Organization
Provider Name (Legal Business Name) : ADVENTIST HEALTH PARTNERS,INC
Provider Business Mailing Address
First Line : PO BOX 7009
Second Line :
City : BOLINGBROOK
State : IL
Zip : 60440-7009
Country : US
Telephone Number : 630-312-7865
Fax Number : 630-312-7902
Provider Business Practice Location Address
First Line : 701 WINTHROP AVE
Second Line :
City : GLENDALE HEIGHTS
State : IL
Zip : 60139-1405
Country : US
Telephone Number : 708-245-4073
Fax Number : 708-245-5614
Authorized Official
Title or Position : DIRECTOR OF MANAGED CARE
Name : MRS. RUBY MANN
Credential :
Telephone Number : 63085668844
Provider Enumeration Date : 06/20/2006
Last Update Date : 01/08/2008

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