Organization Name: | RIVERSIDE HEALTH SYSTEM |
NPI Number: | 1265716450 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | RICHARD SCHILTZ (MANAGER OF BUDGET AND REIMBURSEMENT) |
Mailing Address: | 2080 N State Route 50 Bourbonnais |
State: | IL US |
Postal Code: | 609144410 |
Phone Number: | 8159366012 |
Fax Number: | 8159367231 |
NPI Enumeration Date: | 10/05/2011 |
NPI Last Update Date: | 10/05/2011 |
Replacement NPI: | 0 |
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Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |