Organization Active NPI

Adventist Health Partners, Inc

Doing business as Bolingbrook Neuroscience Institute

  • Neurological Surgery Physician
  • Bolingbrook, IL
National Provider Identifier
1811325160
Registry record updated Oct 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
Legal business name
ADVENTIST HEALTH PARTNERS, INC
Doing business as
Bolingbrook Neuroscience Institute
Practice address
396 Remington Blvd
Suite 140
Bolingbrook, IL 60440-4302
Phone
(630) 570-6600
Fax
(630) 312-2223
NPI assigned
Oct 24, 2013
Last updated
Oct 28, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2013

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
Neurological Surgery Physician 207T00000X NU Primary

Addresses

Primary practice location

396 Remington Blvd
Suite 140
Bolingbrook, IL 60440-4302

Mailing address

396 Remington Blvd
Suite 140
Bolingbrook, IL 60440-4302
Phone (630) 570-6600

Other names 1

  • Bolingbrook Neuroscience Institute 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

396 Remington Blvd
Ste 140
Bolingbrook, IL 60440
Phone (630) 495-9356

Practitioners & affiliated clinicians

Practitioners 1

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": "1382572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1382918400000",
    "number": "1811325160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "396 REMINGTON BLVD",
            "address_2": "SUITE 140",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404302",
            "telephone_number": "630-570-6600",
            "fax_number": "630-312-2223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "396 REMINGTON BLVD",
            "address_2": "SUITE 140",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404302",
            "telephone_number": "630-570-6600",
            "fax_number": "630-312-2223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVENTIST HEALTH PARTNERS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-24",
        "last_updated": "2013-10-28",
        "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": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bolingbrook Neuroscience Institute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bolingbrook, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 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.