# HINSDALE HOSPITAL

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- **Entity:** Organization
- **Status:** Active
- **Other names:** HINSDALE FAMILY MEDICINE CENTER OF BOLINGBROOK
- **Organization subpart:** No

## Provider details

- **NPI number:** 1063541167
- **Authorized official:** MRS. RUBY MANN (DIRECTOR OF MANAGED CARE)
- **Authorized official phone:** (630) 856-6884

## Contact information

- **Practice address:** 420 MEDICAL CENTER DR, BOLINGBROOK, IL 60440-4925
- **Practice address phone:** (630) 226-8000
- **Practice address fax:** (630) 226-8010
- **Mailing address:** 420 MEDICAL CENTER DR, BOLINGBROOK, IL 60440-4925
- **Mailing address phone:** (630) 226-8000
- **Mailing address fax:** (630) 886-8010

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/05/2007
- **Last updated:** 02/19/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | CC5403 | RAILROAD MEDICARE | IL |