Organization Active NPI

Adventist Health Partners, Inc

Doing business as DuPage Center for Surgery and Breast Health

  • Surgery Physician
  • Bloomingdale, IL
National Provider Identifier
1750638573
Registry record updated Jun 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
ADVENTIST HEALTH PARTNERS, INC
Doing business as
DuPage Center for Surgery and Breast Health
Practice address
303 E Army Trail Rd
Suite 304
Bloomingdale, IL 60108-2169
Phone
(630) 856-8677
Fax
(630) 856-9909
NPI assigned
Aug 10, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2017

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

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X Primary

Addresses

Primary practice location

303 E Army Trail Rd
Suite 304
Bloomingdale, IL 60108-2169

Mailing address

303 E Army Trail Rd
Suite 304
Bloomingdale, IL 60108-2169
Phone (630) 856-8677

Other names 1

  • DuPage Center for Surgery and Breast Health Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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

National Provider Directory

Locations

303 E Army Trail Rd
Ste 304
Bloomingdale, IL 60108
Phone (630) 351-8500

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1344556800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1497398400000",
    "number": "1750638573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 E ARMY TRAIL RD",
            "address_2": "SUITE 304",
            "city": "BLOOMINGDALE",
            "state": "IL",
            "postal_code": "601082169",
            "telephone_number": "630-856-8677",
            "fax_number": "630-856-9909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 E ARMY TRAIL RD",
            "address_2": "SUITE 304",
            "city": "BLOOMINGDALE",
            "state": "IL",
            "postal_code": "601082169",
            "telephone_number": "630-856-8677",
            "fax_number": "630-856-9909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVENTIST HEALTH PARTNERS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-10",
        "last_updated": "2017-06-14",
        "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": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DuPage Center for Surgery and Breast Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bloomingdale, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 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.