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Organization
ADVENTIST MIDWEST HEALTH
Active
Organization
ADVENTIST MIDWEST HEALTH
Active
Other names
ADVENTIST LAGRANGE FAMILY MEDICINE CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. RUBY MANN (DIRECTOR OF MANAGED CARE)
(630) 856-6884
Entity
Organization
Contact information
Practice address
5101 WILLOW SPRINGS RD, LA GRANGE, IL 60525-2600
(708) 245-8900
Mailing address
5101 WILLOW SPRINGS RD, LA GRANGE, IL 60525-2600
(708) 245-8900
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1615787
BCBS
—
Enumeration date
02/27/2007
Last updated
04/21/2016
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