Adventist Health Partners, Inc

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

Legal business name

ADVENTIST HEALTH PARTNERS, INC

Practice address

5207 Main St
Downers Grove, IL 60515-4652

Phone

(630) 969-7706

Fax

(630) 971-6373

NPI assigned

Sep 14, 2012

Organization subpart

No

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

Authorized official

Name

Ruby Mann

Title

MGR

Phone

(630) 856-6884

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Healthcare for Women 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": "1347580800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1497225600000",
    "number": "1720338908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5207 MAIN ST",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605154652",
            "telephone_number": "630-969-7706",
            "fax_number": "630-971-6373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5207 MAIN ST",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605154652",
            "telephone_number": "630-969-7706",
            "fax_number": "630-971-6373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVENTIST HEALTH PARTNERS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-14",
        "last_updated": "2017-06-12",
        "status": "A",
        "authorized_official_last_name": "MANN",
        "authorized_official_first_name": "RUBY",
        "authorized_official_title_or_position": "MGR",
        "authorized_official_telephone_number": "630-856-6884"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICARE PTAN",
            "identifier": "400480",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Healthcare for Women",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• All providers in Downers Grove, IL
• Obstetrics & Gynecology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2017; 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.