Adventist Health Partners, Inc
Organization Active NPI Family Medicine Physician · Berwyn, IL
NPI 1659624849 · NPPES record last updated Jun 12, 2017
Key facts
- NPI
- 1659624849
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- ADVENTIST HEALTH PARTNERS, INC
- Practice address
- 6723 Roosevelt Rd
Berwyn, IL 60402-1007 - Phone
- (708) 383-6346
- Fax
- (708) 383-6346
- NPI assigned
- Oct 25, 2012
- Organization subpart
- No
Authorized official
- Name
- Mrs. Ruby Mann
- Title
- Director
- Phone
- (630) 856-6884
Practitioners 2
-
Asad Rafiq, 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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes |
Addresses
Primary practice location
6723 Roosevelt Rd
Berwyn, IL 60402-1007
Mailing address
6723 Roosevelt Rd
Berwyn, IL 60402-1007
Phone (708) 383-6346
Other names
- D.O.C. Family Practice
Other providers in Berwyn, IL
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- Gholamali Afshang
- Vivian I Agosto
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- Haidee Guadalupe Aguilar
- Mario Aguilar
All providers in Berwyn, IL · Family Medicine 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 12, 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.