NPIMap

Organization Active NPI

Adventist Bolingbrook Hospital

Doing business as Uchicago Medicine Adventhealth Pharmacy Bolingbrook

  • Specialty Pharmacy
  • Bolingbrook, IL
National Provider Identifier
1336925817
Registry record updated Nov 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Specialty PharmacyTaxonomy code 3336S0011X
Legal business name
ADVENTIST BOLINGBROOK HOSPITAL
Doing business as
Uchicago Medicine Adventhealth Pharmacy Bolingbrook
Practice address
500 Remington Blvd
Bolingbrook, IL 60440-4906
Phone
(630) 312-3970
Fax
(630) 312-6814
NPI assigned
Aug 31, 2023
Last updated
Nov 12, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2024

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

Authorized official

Name
Tristan Shaw
Title
Chief Financial Officer
Phone
(630) 312-6008

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialty Pharmacy 3336S0011X Primary

Addresses

Primary practice location

500 Remington Blvd
Bolingbrook, IL 60440-4906

Mailing address

500 Remington Blvd
Bolingbrook, IL 60440-4906
Phone (630) 312-3970

Other names 1

  • UCHICAGO MEDICINE ADVENTHEALTH PHARMACY BOLINGBROOK Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Adventist Bolingbrook Hosp8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1693440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731369600000",
    "number": "1336925817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404906",
            "telephone_number": "630-312-3970",
            "fax_number": "630-312-6814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404906",
            "telephone_number": "630-312-3970",
            "fax_number": "630-312-6814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVENTIST BOLINGBROOK HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-31",
        "last_updated": "2024-11-12",
        "certification_date": "2024-11-12",
        "status": "A",
        "authorized_official_last_name": "SHAW",
        "authorized_official_first_name": "TRISTAN",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "630-312-6008"
    },
    "taxonomies": [
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "UCHICAGO MEDICINE ADVENTHEALTH PHARMACY BOLINGBROOK",
            "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 Nov 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.