NPIMap

Organization Active NPI

Adventist Health Partners, Inc

Doing business as Midwest General Surgeons

  • Surgery Physician
  • Bolingbrook, IL
National Provider Identifier
1194965517
Registry record updated Jun 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
ADVENTIST HEALTH PARTNERS, INC
Doing business as
Midwest General Surgeons
Practice address
396 Remington Blvd
Suite 240
Bolingbrook, IL 60440-4920
Phone
(630) 226-0664
Fax
(630) 226-0669
NPI assigned
Feb 25, 2009
Last updated
Jun 14, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2017

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)CodeLicenseStatePrimary
Surgery Physician 208600000X NU Primary

Addresses

Primary practice location

396 Remington Blvd
Suite 240
Bolingbrook, IL 60440-4920

Mailing address

396 Remington Blvd
Ste 240
Bolingbrook, IL 60440-7009
Phone (630) 226-0664

Other names 1

  • Midwest General Surgeons Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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 Directory

Locations

2363 63rd St
Woodridge, IL 60517
Phone 22477355880000

Practitioners & affiliated clinicians

Practitioners 32

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.

View all 32

NPI Registry JSON

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

{
    "created_epoch": "1235520000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1497398400000",
    "number": "1194965517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "396 REMINGTON BLVD",
            "address_2": "STE 240",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604407009",
            "telephone_number": "630-226-0664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "396 REMINGTON BLVD",
            "address_2": "SUITE 240",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404920",
            "telephone_number": "630-226-0664",
            "fax_number": "630-226-0669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVENTIST HEALTH PARTNERS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-25",
        "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": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Midwest General Surgeons",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bolingbrook, IL

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.

Verify at the official NPI Registry.