Riverside Medical Center

NPI #1619144870 in Kankakee, Illinois

Provider Information

NPI Number: 1619144870
Entity Type: Organization
Organization Name: Riverside Medical Center
Subpart: Yes (part of a larger organization)
Parent Organization: RIVERSIDE MEDICAL CENTER
Primary Specialty: Rehabilitation, Substance Use Disorder Unit
Enumeration Date: May 15, 2008
Last Updated: Jul 28, 2016

Practice Location

Address: 350 N WALL ST
City: Kankakee
State: Illinois
ZIP Code: 60901-2901
Phone: (815) 935-7256

Authorized Official

Name: MR. BILL W DOUGLAS
Title: VICE PRESIDENT AND CFO
Phone: (815) 935-7256

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Rehabilitation, Substance Use Disorder — Rehabilitation, Substance Use Disorder	261QR0405X
Substance Abuse Rehabilitation Facility - Substance Abuse Treatment, Children — Substance Abuse Treatment, Children	3245S0500X
General Acute Care Hospital	282N00000X
Substance Abuse Rehabilitation Facility	324500000X
Rehabilitation, Substance Use Disorder Unit	276400000X	Primary

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