Provider Demographics
NPI:1821020132
Name:ADVENTIST MIDWEST HEALTH
Entity Type:Organization
Organization Name:ADVENTIST MIDWEST HEALTH
Other - Org Name:ADVENTIST ST. THOMAS HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:HARMAT
Authorized Official - Middle Name:
Authorized Official - Last Name:BEEBE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-856-6001
Mailing Address - Street 1:119 E OGDEN AVE
Mailing Address - Street 2:SUITE 111
Mailing Address - City:HINSDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60521-3590
Mailing Address - Country:US
Mailing Address - Phone:630-856-6990
Mailing Address - Fax:630-312-7975
Practice Address - Street 1:119 E OGDEN AVE
Practice Address - Street 2:SUITE 111
Practice Address - City:HINSDALE
Practice Address - State:IL
Practice Address - Zip Code:60521-3590
Practice Address - Country:US
Practice Address - Phone:630-856-6990
Practice Address - Fax:630-312-7975
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ADVENTIST MIDWEST HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-07
Last Update Date:2023-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2002426251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL9513OtherBLUE CROSS BLUE SHIELD IL
IL9513OtherBLUE CROSS BLUE SHIELD IL
IL=========004Medicaid