Organization Active NPI

Adventist Glenoaks Hospital

Doing business as Adventist Glen Oaks Cancer Center

  • Hematology & Oncology Physician
  • Glendale Heights, IL
National Provider Identifier
1861807356
Registry record updated Jul 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
Legal business name
ADVENTIST GLENOAKS HOSPITAL
Doing business as
Adventist Glen Oaks Cancer Center
Practice address
701 Winthrop Ave
Glendale Heights, IL 60139-1405
Phone
(630) 545-4900
NPI assigned
Jun 24, 2014
Last updated
Jul 22, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2014

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

Authorized official

Name
Ruby Mann
Title
Director
Phone
(630) 856-6864

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RH0003X Primary

Addresses

Primary practice location

701 Winthrop Ave
Glendale Heights, IL 60139-1405

Mailing address

701 Winthrop Ave
Glendale Heights, IL 60139-1405

Other names 1

  • Adventist Glen Oaks Cancer Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040122000516 IL Part B Supplier - Clinic/Group Practice 3173425931 Receives reassigned benefits from 4 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Glendale Heights, IL

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 2

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": "1403568000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1405987200000",
    "number": "1861807356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 WINTHROP AVE",
            "city": "GLENDALE HEIGHTS",
            "state": "IL",
            "postal_code": "601391405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 WINTHROP AVE",
            "city": "GLENDALE HEIGHTS",
            "state": "IL",
            "postal_code": "601391405",
            "telephone_number": "630-545-4900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVENTIST GLENOAKS HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-24",
        "last_updated": "2014-07-22",
        "status": "A",
        "authorized_official_last_name": "MANN",
        "authorized_official_first_name": "RUBY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "630-856-6864"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Adventist Glen Oaks Cancer Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Glendale Heights, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2014; 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.