NPIMap

Organization Active NPI

Adventist Health Partners, Inc

Doing business as Hinsdale Primary Care

  • Family Medicine Physician
  • Hinsdale, IL
National Provider Identifier
1952339939
Registry record updated Jun 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ADVENTIST HEALTH PARTNERS, INC
Doing business as
Hinsdale Primary Care
Practice address
911 N Elm St
Suite 123
Hinsdale, IL 60521-3634
Phone
(630) 325-5709
Fax
(630) 325-0388
NPI assigned
Jun 29, 2006
Last updated
Jun 14, 2017By the provider in NPPES
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 of Managed Care
Phone
(630) 856-6884

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

911 N Elm St
Suite 123
Hinsdale, IL 60521-3634

Mailing address

911 N Elm St
Ste 123
Hinsdale, IL 60521-3634
Phone (630) 325-5709

Other names 1

  • HINSDALE PRIMARY CARE 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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
14D0932055Hinsdale Primary Care Associates911 N Elm Suite 123, Hinsdale, IL 60521Provider-performed microscopyAug 11, 2027

National Provider Directory

National Provider Directory

Locations

911 N Elm St
Ste 123
Hinsdale, IL 60521
Phone (630) 325-5709

Practitioners & affiliated clinicians

Practitioners 66

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.

View all 66

NPI Registry JSON

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1497398400000",
    "number": "1952339939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "911 N ELM ST",
            "address_2": "STE 123",
            "city": "HINSDALE",
            "state": "IL",
            "postal_code": "605213634",
            "telephone_number": "630-325-5709",
            "fax_number": "630-325-0388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "911 N ELM ST",
            "address_2": "SUITE 123",
            "city": "HINSDALE",
            "state": "IL",
            "postal_code": "605213634",
            "telephone_number": "630-325-5709",
            "fax_number": "630-325-0388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVENTIST HEALTH PARTNERS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-29",
        "last_updated": "2017-06-14",
        "status": "A",
        "authorized_official_last_name": "MANN",
        "authorized_official_first_name": "RUBY",
        "authorized_official_title_or_position": "DIRECTOR OF MANAGED CARE",
        "authorized_official_telephone_number": "630-856-6884",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HINSDALE PRIMARY CARE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hinsdale, 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.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.