Provider Demographics
NPI:1447270780
Name:ADVENTIST MIDWEST HEALTH
Entity type:Organization
Organization Name:ADVENTIST MIDWEST HEALTH
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:CULLY
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAPMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-856-6062
Mailing Address - Street 1:120 N OAK STREET
Mailing Address - Street 2:
Mailing Address - City:HINSDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60521
Mailing Address - Country:US
Mailing Address - Phone:630-856-9000
Mailing Address - Fax:630-312-7975
Practice Address - Street 1:120 N OAK STREET
Practice Address - Street 2:
Practice Address - City:HINSDALE
Practice Address - State:IL
Practice Address - Zip Code:60521
Practice Address - Country:US
Practice Address - Phone:630-856-9000
Practice Address - Fax:630-312-7975
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ADVENTIST MIDWEST HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-20
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0000976273R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273R00000XHospital UnitsPsychiatric Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
14S122Medicare Oscar/Certification
IL14S122Medicare ID - Type Unspecified