Provider Demographics
NPI:1447501879
Name:EDWARD HEALTH VENTURES
Entity type:Organization
Organization Name:EDWARD HEALTH VENTURES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BILL
Authorized Official - Middle Name:
Authorized Official - Last Name:KOTTMANN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-646-3950
Mailing Address - Street 1:27555 DIEHL RD
Mailing Address - Street 2:ENTRANCE B
Mailing Address - City:WARRENVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60555-3849
Mailing Address - Country:US
Mailing Address - Phone:630-646-3950
Mailing Address - Fax:630-548-6832
Practice Address - Street 1:801 S WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-7430
Practice Address - Country:US
Practice Address - Phone:630-527-3002
Practice Address - Fax:630-527-2840
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-25
Last Update Date:2014-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL174400000X, 282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes282N00000XHospitalsGeneral Acute Care Hospital
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty