Adventist Health Partners, Inc

Primary specialty

Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X

Legal business name

ADVENTIST HEALTH PARTNERS, INC

Practice address

1012 95TH St
Suite 8
Naperville, IL 60564-5041

Phone

(630) 778-9444

Fax

(630) 778-9424

NPI assigned

May 19, 2011

Organization subpart

No

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

Authorized official

Name

Mrs. Ruby Mann

Title

Director

Phone

(630) 856-6884

Specialties & licenses 1

Addresses

Other names 1

• Midwest Family & Sports Medicine Center Doing business as

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

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

{
    "created_epoch": "1305763200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1360886400000",
    "number": "1659664936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1012 95TH ST STE 3",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605645040",
            "telephone_number": "630-778-9444",
            "fax_number": "630-778-9424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1012 95TH ST",
            "address_2": "SUITE 8",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605645041",
            "telephone_number": "630-778-9444",
            "fax_number": "630-778-9424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVENTIST HEALTH PARTNERS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-19",
        "last_updated": "2013-02-15",
        "status": "A",
        "authorized_official_last_name": "MANN",
        "authorized_official_first_name": "RUBY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "630-856-6884",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Sports Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Midwest Family & Sports Medicine Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Sports Medicine (Family Medicine) Physician in Naperville, IL
• Providers in Naperville, IL by specialty
• Sports Medicine (Family Medicine) Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.