Organization
ADVENTIST HEALTH PARTNERS, INC
Active
Other names
WOOD DALE FAMILY MEDICINE
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. RUBY MANN (DIRECTOR)
(630) 856-6889
Entity
Organization
Contact information
Practice address
199 S ADDISON RD, SUITE 108, WOOD DALE, IL 60191-1929
(630) 616-7223
(630) 616-7224
Mailing address
199 S ADDISON RD, STE 108, WOOD DALE, IL 60191-1929
(630) 616-7223
(630) 616-7224
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
400480
MEDICARE PTAN
IL
Enumeration date
07/27/2009
Last updated
02/19/2013
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