Adventist Health Partners,Inc

Organization Active NPI Internal Medicine Physician · Riverside, IL

NPI 1356386809 · NPPES record last updated Feb 19, 2013

Key facts

NPI
1356386809
Entity type
Organization (NPI type 2)
Primary specialty
Internal Medicine Physician 207R00000X
Legal business name
ADVENTIST HEALTH PARTNERS,INC
Practice address
7234 Ogden Ave
Riverside, IL 60546-2269
Phone
(708) 447-1177
Fax
(708) 447-9235
NPI assigned
Jun 18, 2006
Organization subpart
No

Authorized official

Name
Mrs. Ruby Mann
Title
Director of Managed Care
Phone
(630) 856-6884

Medicare participation

Medicare fee-for-service enrollment
Enrolled in IL

Medicare enrollment records

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

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician
Group: 193400000X SINGLE SPECIALTY GROUP
207R00000X Yes

Addresses

Primary practice location

7234 Ogden Ave
Riverside, IL 60546-2269

Mailing address

7234 Ogden Ave
Riverside, IL 60546-2269
Phone (708) 447-1177

Other names

  • ADULT MEDICINE PHYSICIANS OF RIVERSIDE Doing business as

Other providers in Riverside, IL

All providers in Riverside, IL · Internal Medicine Physician in Illinois

Sources for this page

Verify at the official NPI Registry.