Organization
ADVENTIST BOLINGBROOK HOSPITAL
Active
Other names
UChicago Medicine AdventHealth Pharmacy Bolingbrook
Organization subpart
No
Provider details
NPI number
Authorized official
TRISTAN SHAW (CHIEF FINANCIAL OFFICER)
(630) 312-6008
Entity
Organization
Contact information
Practice address
500 REMINGTON BLVD, BOLINGBROOK, IL 60440-4906
(630) 312-3970
(630) 312-6814
Mailing address
500 REMINGTON BLVD, BOLINGBROOK, IL 60440-4906
(630) 312-3970
(630) 312-6814
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
054-017593
IL
3336C0004X
Compounding Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1184923260
—
IL
01
—
2129034
PK
—
Enumeration date
03/15/2011
Last updated
11/08/2024
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