Organization
ADVENTIST HEALTH PARTNERS,INC
Active
Other names
ADVENTIST MIDWEST GERIATRICS SPECIALISTS LA GRANGE
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. RUBY MANN (DIRECTOR)
(630) 856-6884
Entity
Organization
Contact information
Practice address
5101 WILLOW SPRINGS RD, LA GRANGE, IL 60525-2600
(708) 245-4073
(708) 245-5614
Mailing address
5101 WILLOW SPRINGS RD, LA GRANGE, IL 60525-2600
(708) 245-4073
(708) 245-5614
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CN4921
RRMC
IL
Enumeration date
07/31/2006
Last updated
02/13/2013
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