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RIVERSIDE MEDICAL CENTER NPI 1619144870


NPI Information

NPI: 1619144870
Provider Name: RIVERSIDE MEDICAL CENTER
Classification: Rehabilitation, Substance Use Disorder Unit - 276400000X
Entity Type: Organization
Address:
350 N WALL ST
KANKAKEE, IL
ZIP 60901
Phone: (815) 935-7256
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RIVERSIDE MEDICAL CENTER is a rehabilitation substance use disorder unit in Kankakee, IL. The provider is a distinct part of a hospital that provides medically monitored, interdisciplinary addiction-focused treatment to patients/clients who have psychoactive substance use disorders (commonly referred to as alcohol and drug abuse or substance abuse.) RIVERSIDE MEDICAL CENTER NPI is 1619144870. The provider is registered as an organization entity type.

The provider's business location address is:

350 N WALL ST
KANKAKEE, IL
ZIP 60901-901
Phone: (815) 935-7256
Fax: (815) 935-7490

The provider's authorized official is Bill W Douglas .
The authorized official title is Vice President And Cfo and has the following contact phone number (815) 935-7256.

The enumeration date for this NPI number is 5/15/2008 and was last updated on 7/28/2016.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QR0405XClinic/CenterRehabilitation, Substance Use Disorder0002014ILLINOISNo
23245S0500XSubstance Abuse Rehabilitation FacilitySubstance Abuse Treatment, Children0002014ILLINOISNo
3282N00000XGeneral Acute Care Hospital0002014ILLINOISNo
4324500000XSubstance Abuse Rehabilitation Facility0002014ILLINOISNo
5276400000XRehabilitation, Substance Use Disorder Unit0002014ILLINOISYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1=========009MEDICAIDILLINOIS

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: 4/28/2024

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