Active NPI
Adventist Health Partners, Inc
Doing business as Bolingbrook Neuroscience Institute
- Neurological Surgery Physician
- Bolingbrook, IL
National Provider Identifier
1811325160
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurological Surgery Physician
- 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, 2013
- Organization subpart
- No
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
| 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
National Provider DirectoryLocations
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.
-
- Surgery Physician
- Bolingbrook, IL
- NPI 1699873778
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
- Adventist Health Partners, Inc (Adventist Bolingbrook Anesthesia)
- Adventist Health Partners, Inc (Adventist Bolingbrook Hospital OB/GYN Hospitalists)
- Adventist Health Partners, Inc (Bolingbrook Family Health Care)
- Adventist Health Partners, Inc (Bolingbrook Women's Healthcare)
- Adventist Health Partners, Inc (Bolingbrook Urology)
- Adventist Health Partners, Inc (Boling Primary Care)
- Adventist Health Partners, Inc. (Avalon Cancer Care)
- Adventist Health Partners, Inc. (Family Medical Center of Bolingbrook)
- Advocate Health and Hopsitals Corporation (Advocate Childhood Trauma Treatment Program)
- Aesthetic Dental Health Center, LTD. (Aesthetic Family Dentistry)
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.