# ADVENTIST BOLINGBROOK HOSPITAL

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- **Entity:** Organization
- **Status:** Active
- **Other names:** UChicago Medicine AdventHealth Pharmacy Bolingbrook
- **Organization subpart:** No

## Provider details

- **NPI number:** 1184923260
- **Authorized official:** TRISTAN SHAW (CHIEF FINANCIAL OFFICER)
- **Authorized official phone:** (630) 312-6008

## Contact information

- **Practice address:** 500 REMINGTON BLVD, BOLINGBROOK, IL 60440-4906
- **Practice address phone:** (630) 312-3970
- **Practice address fax:** (630) 312-6814
- **Mailing address:** 500 REMINGTON BLVD, BOLINGBROOK, IL 60440-4906
- **Mailing address phone:** (630) 312-3970
- **Mailing address fax:** (630) 312-6814

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 054-017593 | IL | Yes |
| 3336C0004X | Compounding Pharmacy | — | NULL | — |
| 3336S0011X | Specialty Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 03/15/2011
- **Last updated:** 11/08/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1184923260 | — | IL |
| 01 | — | 2129034 | PK | — |