Active NPI
Adventist Health Partners, Inc
Doing business as Gastrointestinal Specialty Care
- Gastroenterology Physician
- Bolingbrook, IL
National Provider Identifier
1174815229
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- Legal business name
- ADVENTIST HEALTH PARTNERS, INC
- Doing business as
- Gastrointestinal Specialty Care
- Practice address
- 396 Remington Blvd
Suite 260
Bolingbrook, IL 60440-4302 - Phone
- (630) 312-7590
- Fax
- (630) 226-0669
- NPI assigned
- May 9, 2011
- Last updated
- Jun 14, 2017
- Organization subpart
- No
NPPES NPI Registry
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) 856-6884
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | Primary |
Addresses
Primary practice location
396 Remington Blvd
Suite 260
Bolingbrook, IL 60440-4302
Mailing address
396 Remington Blvd
Ste 260
Bolingbrook, IL 60440-4302
Phone (630) 312-7590
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 399980 | Other | IL | GROUP PTAN |
Other names 1
- Gastrointestinal Specialty Care
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040127000064 | IL | Part B Supplier - Clinic/Group Practice | 0244135762 |
Receives reassigned benefits from 392 practitioners This NPI is an additional NPI on the enrollment |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 6
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Advanced Practice Midwife
- Hinsdale, IL
- NPI 1649953381
-
- Anesthesiology Physician
- Bolingbrook, IL
- NPI 1528168523
-
- Family Medicine Physician
- Bloomingdale, IL
- NPI 1255381927
-
- Surgery Physician
- Hinsdale, IL
- NPI 1982127114
-
- Family Medicine Physician
- Westchester, IL
- NPI 1952352254
-
- Psychiatry Physician
- South Bend, IN
- NPI 1952460933
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1304899200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1497398400000",
"number": "1174815229",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "396 REMINGTON BLVD",
"address_2": "STE 260",
"city": "BOLINGBROOK",
"state": "IL",
"postal_code": "604404302",
"telephone_number": "630-312-7590",
"fax_number": "630-226-0669"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "396 REMINGTON BLVD",
"address_2": "SUITE 260",
"city": "BOLINGBROOK",
"state": "IL",
"postal_code": "604404302",
"telephone_number": "630-312-7590",
"fax_number": "630-226-0669"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ADVENTIST HEALTH PARTNERS, INC",
"organizational_subpart": "NO",
"enumeration_date": "2011-05-09",
"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": "630-856-6884",
"authorized_official_name_prefix": "Mrs."
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUP PTAN",
"identifier": "399980",
"state": "IL"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Gastrointestinal Specialty Care",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Bolingbrook, IL
- Adventist Bolingbrook Hospital (Adventhealth Bolingbrook)
- Adventist Bolingbrook Hospital (Adventist Bolingbrook Cancer Center)
- Adventist Business Health
- Adventist Health Partners, Inc (Associates of Inpatient Management)
- Adventist Health Partners, Inc (Bolingbrook Family Medicine)
- Adventist Health Partners, Inc (Midwest General Surgeons)
- Adventist Health Partners, Inc (Midwest Bone and Joint Specialists)
- Adventist Health Partners, Inc (Midwest Concussion & Sports Medicine Center)
- Adventist Health Partners, Inc (Adventist Bolingbrook Anesthesia)
- Adventist Health Partners, Inc (Adventist Bolingbrook Hospital OB/GYN Hospitalists)
Sources for this page
- 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.