Provider Demographics
NPI:1760768121
Name:ADVENTIST HEALTH PARTNERS, INC
Entity Type:Organization
Organization Name:ADVENTIST HEALTH PARTNERS, INC
Other - Org Name:WEST SUBURBAN PEDIATRIC ENDOCRINOLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
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 1:12 SALT CREEK LN
Mailing Address - Street 2:STE 106
Mailing Address - City:HINSDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60521-8605
Mailing Address - Country:US
Mailing Address - Phone:630-981-0032
Mailing Address - Fax:630-241-0884
Practice Address - Street 1:12 SALT CREEK LN
Practice Address - Street 2:STE 106
Practice Address - City:HINSDALE
Practice Address - State:IL
Practice Address - Zip Code:60521-8605
Practice Address - Country:US
Practice Address - Phone:630-981-0032
Practice Address - Fax:630-241-0884
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-31
Last Update Date:2011-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080P0205XAllopathic & Osteopathic PhysiciansPediatricsPediatric EndocrinologyGroup - Multi-Specialty