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RIVERA MEDICAL OFFICE LLC NPI 1689883035


NPI Information

NPI: 1689883035
Provider Name: RIVERA MEDICAL OFFICE, LLC

Former Legal Business Name: RENATO B. RIVERA, MD, LLC

Classification: Surgery - 208600000X
Entity Type: Organization
Address:
1110 MULLIKEN ST
CARLYLE, IL
ZIP 62231
Phone: (618) 594-3613
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RIVERA MEDICAL OFFICE, LLC is a surgery in Carlyle, IL. The provider is a general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. RIVERA MEDICAL OFFICE, LLC NPI is 1689883035. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Former Legal Business Name Is Renato B. Rivera, Md, Llc.

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 5/22/2007 and was last updated on 5/12/2008.


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 Medicine036096480ILLINOISNo
2208000000XPediatrics036096480ILLINOISNo
3208600000XSurgery036045712ILLINOISYes

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
1566130MEDICARE OSCAR/CERTIFICATION
21400038OTHERILLINOISBLUECROSS PROV #

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: 5/5/2024

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