RIVERA MEDICAL LLC NPI 1467756338

NPI Information

  • NPI: 1467756338
  • Provider Name: RIVERA MEDICAL, LLC
  • Classification: Clinic/Center - 261QR1300X
  • Specialization: Rural Health
  • Entity Type: Organization
  • Address: 1110 MULLIKEN ST
    CARLYLE, IL
    ZIP 62231
  • Phone: (618) 594-3613

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NPI Details

RIVERA MEDICAL, LLC is a rural health clinic center in Carlyle, IL. RIVERA MEDICAL, LLC NPI is 1467756338. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1110 MULLIKEN ST
CARLYLE, IL
ZIP 62231-233
Phone: (618) 594-3613
Fax: (618) 594-4799

The provider's authorized official is Lisa Rivera .
The authorized official title is Office Manager and has the following contact phone number (618) 594-3613.

The enumeration date for this NPI number is 1/6/2011 and was last updated on 6/29/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207R00000XInternal Medicine036-096480ILLINOISNo
2208000000XPediatrics036-096480ILLINOISNo
3261QR1300XClinic/CenterRural Health036-096480ILLINOISYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1148946MEDICARE OSCAR/CERTIFICATIONILLINOIS
2G96384MEDICARE UPINILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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