| Organization Name: | RIVERSIDE CORPORATE HEALTH SERVICES |
| NPI Number: | 1366733685 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | PAM BALL (CORPORATE HEALTH PROGRAM MANAGER) |
| Mailing Address: | 400 S Kennedy Dr Suite 400 Bradley |
| State: | IL US |
| Postal Code: | 609152682 |
| Phone Number: | 8159357532 |
| Fax Number: | 8159357495 |
| NPI Enumeration Date: | 04/20/2011 |
| NPI Last Update Date: | 04/20/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QX0100X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Occupational Medicine |
| Taxonomy Definition: | |