Adventist Health Partners, Inc

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

ADVENTIST HEALTH PARTNERS, INC

Practice address

1012 95TH St
Suite 3
Naperville, IL 60564-5041

Phone

(630) 856-8790

Fax

(630) 548-3421

NPI assigned

Oct 4, 2013

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Ruby Mann

Title

Director

Phone

(630) 856-6844

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Suburban Midwest Medicine Doing business as

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lisa Fortman, MD

  • Family Medicine Physician
  • Hinsdale, IL
  • NPI 1225095565
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1380844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1497398400000",
    "number": "1124455126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1012 95TH ST",
            "address_2": "SUITE 3",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605645041",
            "telephone_number": "630-856-8790",
            "fax_number": "630-548-3421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1012 95TH ST",
            "address_2": "SUITE 3",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605645041",
            "telephone_number": "630-856-8790",
            "fax_number": "630-548-3421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVENTIST HEALTH PARTNERS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-04",
        "last_updated": "2017-06-14",
        "status": "A",
        "authorized_official_last_name": "MANN",
        "authorized_official_first_name": "RUBY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "630-856-6844",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP PTAN",
            "identifier": "399980",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Suburban Midwest Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Internal Medicine Physician in Naperville, IL
• Providers in Naperville, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.