Organization
ADVENTIST MIDWEST HEALTH
Active
Other names
LAGRANGE MEMORIAL HOSPITAL CARDIOLOLGY
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. RUBY MANN (DIRECTOR OF MANAGED CARE)
(630) 856-6884
Entity
Organization
Contact information
Practice address
5101 WILLOW SPRINGS RD, LA GRANGE, IL 60525-2600
(708) 245-3650
Mailing address
5101 WILLOW SPRINGS RD, LA GRANGE, IL 60525-2600
(708) 245-3650
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CG5784
RAILROAD MEDICARE PTAN
IL
Enumeration date
12/04/2006
Last updated
04/21/2016
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