Provider Demographics
NPI:1225291008
Name:ADVENTIST HEALTH PARTNERS, INC
Entity Type:Organization
Organization Name:ADVENTIST HEALTH PARTNERS, INC
Other - Org Name:MIDWEST BONE AND JOINT SPECIALISTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF FINANCIAL SERVICES
Authorized Official - Prefix:MRS
Authorized Official - First Name:RUBY
Authorized Official - Middle Name:
Authorized Official - Last Name:MANN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-856-6884
Mailing Address - Street 1:396 REMINGTON BLVD
Mailing Address - Street 2:STE 130
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440-4302
Mailing Address - Country:US
Mailing Address - Phone:630-759-1248
Mailing Address - Fax:630-759-0717
Practice Address - Street 1:396 REMINGTON BLVD
Practice Address - Street 2:STE 130
Practice Address - City:BOLINGBROOK
Practice Address - State:IL
Practice Address - Zip Code:60440-4302
Practice Address - Country:US
Practice Address - Phone:630-759-1248
Practice Address - Fax:630-759-0717
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-02
Last Update Date:2017-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036096001207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL399980OtherMEDICARE PTAN