Adventist Health Partners,Inc
Organization Active NPI Surgery Physician · Lagrange, IL
NPI 1366487704 · NPPES record last updated Jun 14, 2017
Key facts
- NPI
- 1366487704
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Surgery Physician 208600000X
- Legal business name
- ADVENTIST HEALTH PARTNERS,INC
- Practice address
- 5201 Willow Springs Rd
Ste 290
Lagrange, IL 60525-6537 - Phone
- (708) 579-0018
- Fax
- (708) 579-7571
- NPI assigned
- Jun 19, 2006
- Organization subpart
- No
Authorized official
- Name
- Mrs. Ruby Mann
- Title
- Director of Managed Care
- Phone
- (630) 856-6884
Corporate family (same tax ID) 10
Practitioners 23
-
Kimberley Renee Baumhart, FNP-BC
-
Nomin Bayarsaikhan, PA-C
-
David A Cusick, M.D.
-
Laura Fetzer, NURSE PRACTITIONER
-
Patrick Francis, DO
-
Gurvinder S Herlihy, PAC
-
Thomas Theodore Kason, M.D.
-
Asad Khan, MD
-
Jihad Kudsi, MD
-
Alexandra H Pape, CNM
-
Milen P Peev, MD
-
Dominick J Stella, M.D.
-
Antony R Tharian, M.D.
-
Sammy Hamad, DO
-
Devin Emory Rogers, MD, MPH
-
Erin Radosevich, NP
-
Eric Yang, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Medicare enrollment records
| 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
- Tax ID family
- Osteopathic Physician a
Locations
911 N Elm St
Ste 301
Hinsdale, IL 60521
Phone (630) 856-8650
5201 Willow Springs Rd
Ste 290
La Grange Highlands, IL 60525
5201 Willow Springs Rd
Ste 380
La Grange Highlands, IL 60525
Phone (708) 354-2550
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician |
208600000X | Yes |
Addresses
Primary practice location
5201 Willow Springs Rd
Ste 290
Lagrange, IL 60525-6537
Mailing address
5201 S Willow Springs
Ste 290
La Grange, IL 60525
Phone (708) 579-0018
Other names
- CONSULTING SURGEONS
Other providers in Lagrange, IL
All providers in Lagrange, IL · Surgery Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 14, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.