Organization
ADVENTIST HEALTH PARTNERS, INC
Active
Other names
Family Medicine of Western Springs
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. RUBY MANN (DIRECTOR)
(630) 856-6884
Entity
Organization
Contact information
Practice address
5201 WILLOW SPRINGS RD, STE 160, LA GRANGE, IL 60525-6537
(708) 354-0920
(708) 354-0974
Mailing address
5201 S. WILLOW SPRINGS RD, STE 160, LAGRANGE, IL 60525
(708) 354-0920
(708) 354-0974
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
403270
MEDICARE GROUP PTAN
IL
Enumeration date
07/30/2010
Last updated
06/14/2017
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