NPIMap

Organization Active NPI

Adventist Midwest Health

Doing business as Adventhealth Family Medicine Center Hinsdale

  • Family Medicine Physician
  • Hinsdale, IL
National Provider Identifier
1366579443
Registry record updated Nov 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ADVENTIST MIDWEST HEALTH
Doing business as
Adventhealth Family Medicine Center Hinsdale
Hinsdale Family Medicine Center
Practice address
135 N Oak St
Hinsdale, IL 60521-3860
Phone
(630) 856-8900
Fax
(630) 856-8923
NPI assigned
Feb 27, 2007
Last updated
Nov 14, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2024

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

Authorized official

Name
Cully Chapman
Title
Chief Financial Officer
Phone
(630) 856-6006

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X
Clinical Social Worker 1041C0700X
Dermatology Physician 207N00000X
Family Medicine Physician 207Q00000X Primary
Obstetrics & Gynecology Physician 207V00000X
Psychiatry Physician 2084P0800X
Child & Adolescent Psychiatry Physician 2084P0804X

Addresses

Primary practice location

135 N Oak St
Hinsdale, IL 60521-3860

Mailing address

PO Box 775248
Chicago, IL 60677-5248

Other identifiers 2

IdentifierTypeStateIssuer
CC5403OtherILRRMC
2215411OtherBCBS

Other names 2

  • ADVENTHEALTH FAMILY MEDICINE CENTER HINSDALE Doing business as
  • HINSDALE FAMILY MEDICINE CENTER Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040126000676 IL Part B Supplier - Clinic/Group Practice 4486556727 Receives reassigned benefits from 41 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Hinsdale, IL

Other NPIs on the same Medicare enrollment 6

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
14D2163951Hinsdale Family Medicine Center135 N Oak St, Hinsdale, IL 60521Provider-performed microscopyMar 24, 2027

National Provider Directory

National Provider Directory
Tax ID family
Hinsdale Family Medicin13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

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

Locations

644 S Weber Rd
Romeoville, IL 60446
Phone (630) 856-8620

Practitioners & 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.

NPI Registry JSON

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731542400000",
    "number": "1366579443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 775248",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606775248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 N OAK ST",
            "city": "HINSDALE",
            "state": "IL",
            "postal_code": "605213860",
            "telephone_number": "630-856-8900",
            "fax_number": "630-856-8923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVENTIST MIDWEST HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-27",
        "last_updated": "2024-11-14",
        "certification_date": "2024-11-14",
        "status": "A",
        "authorized_official_last_name": "CHAPMAN",
        "authorized_official_first_name": "CULLY",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "630-856-6006"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRMC",
            "identifier": "CC5403",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "2215411",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ADVENTHEALTH FAMILY MEDICINE CENTER HINSDALE",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "HINSDALE FAMILY MEDICINE CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hinsdale, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.