Organization
ADVENTIST BOLINGBROOK HOSPITAL
Active
Organization
ADVENTIST BOLINGBROOK HOSPITAL
Active
Other names
ADVENTHEALTH BOLINGBROOK, Bolingbrook Hospital Cardiology, UCHICAGO MEDICINE ADVENTHEALTH 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) 312-5000
Mailing address
500 REMINGTON BLVD, BOLINGBROOK, IL 60440-4906
(630) 312-5000
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
IL1794
MEDICARE GROUP PTAN
IL
Enumeration date
01/16/2009
Last updated
02/11/2025
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