RIVERSIDE MEDICAL CENTER (NPI# 1619144870) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619144870 |
| Entity Type | Organization |
| Organization Name | RIVERSIDE MEDICAL CENTER |
| Practice Address |
350 N Wall St Kankakee IL 60901-2901 |
| Practice Telephone | 8159357256 |
| Practice Fax Number | 8159357490 |
| Mailing Telephone | 8159357256 |
| Mailing Fax Number | 8159357490 |
| Enumeration Date | 2008-05-15 |
| Last Update Date | 2016-07-28 |
| Authorized Official Name | MR. BILL W DOUGLAS (VICE PRESIDENT AND CFO) |
| Authorized Official Telephone | 8159357256 |
| Is Organization Subpart | Y |
| Parent Organization Name | RIVERSIDE MEDICAL CENTER |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
0002014 | IL | Ambulatory Health Care Facilities |
| N | 3245S0500X |
Substance Abuse Rehabilitation Facility Specialization: Substance Abuse Treatment, Children |
0002014 | IL | Residential Treatment Facilities |
| N | 282N00000X | General Acute Care Hospital | 0002014 | IL | Hospitals |
| N | 324500000X | Substance Abuse Rehabilitation Facility | 0002014 | IL | Residential Treatment Facilities |
| Y | 276400000X | Rehabilitation, Substance Use Disorder Unit | 0002014 | IL | Hospital Units |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538634977 | Riverside Medical Center | Clinic/Center | 806 Riverside Dr Ste A, Franklinton, LA 70438-3603 | 2018-10-12 |
| 1558774869 | Riverside Medical Center | General Acute Care Hospital | 260 S Washington Ave, Kankakee, IL 60901-3729 | 2014-06-04 |
| 1174780613 | Riverside Medical Center | Clinic/Center | 3609 Alexandria Pike, Cold Spring, KY 41076-2029 | 2008-05-21 |
| 1740346451 | Riverside Medical Center | Home Health | 611 Division Street, Peotone, IL 60468-9590 | 2006-12-28 |
| 1982703005 | Riverside Medical Center | Family Medicine | 3400 S Main St., Hopkins Park, IL 60944-9998 | 2006-09-22 |
| 1417056532 | Riverside Medical Center | Family Medicine | 1701 E Court St., Kankakee, IL 60901 | 2006-09-22 |
| 1518955541 | Riverside Medical Center | Clinic/Center | 806b Riverside Dr, Franklinton, LA 70438-3603 | 2005-10-13 |
| 1699290239 | Riverside Medical Center | Family Medicine | 51704 Highway 438, Franklinton, LA 70438-7488 | 2017-08-04 |
| 1710438361 | Riverside Medical Center | Clinic/Center | 807 Riverside Dr, Franklinton, LA 70438-3635 | 2016-10-19 |
| 1952751679 | Riverside Medical Center | Clinic/Center | 709 Riverside Dr., Franklinton, LA 70438 | 2016-06-14 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | RIVERSIDE MEDICAL CENTER | 350 N Wall St, Kankakee, IL 60901-2901 |
| Street Address |
350 N WALL ST |
| City | KANKAKEE |
| State | IL |
| Zip Code | 60901-2901 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710967955 | Yasser A Alhaj-hussein | Anesthesiology | 350 N Wall St, Dept of Anesthesesia, Kankakee, IL 60901-2901 | 2006-01-21 |
| 1932727229 | Elizabeth Ann Christian | Speech-Language Pathologist | 350 N Wall St, Kankakee, IL 60901-2901 | 2020-07-13 |
| 1649897471 | Taryn Mackenzie Linke | Speech-Language Pathologist | 350 N Wall St, Kankakee, IL 60901-2901 | 2020-06-27 |
| 1629693726 | Stephen Tulley | Internal Medicine | 350 N Wall St, Kankakee, IL 60901-2991 | 2020-06-15 |
| 1891310991 | Matthew Sutherland | Internal Medicine | 350 N Wall St, Kankakee, IL 60901-2991 | 2020-06-15 |
| 1962026302 | Kelsie Joann Jamilia Winger | Psychiatry & Neurology | 350 N Wall St, Kankakee, IL 60901-2991 | 2020-06-01 |
| 1346863321 | Ahmed Ismail | Internal Medicine | 350 N Wall St, Kankakee, IL 60901-2901 | 2020-05-25 |
| 1013539683 | Megan L Lucas | Pharmacist | 350 N Wall St, Kankakee, IL 60901-2991 | 2020-05-17 |
| 1568084523 | Alketa Zyka | Internal Medicine | 350 N Wall St, Kankakee, IL 60901-2901 | 2020-05-13 |
| 1134741028 | Shahzaib Khan | Psychiatry & Neurology | 350 N Wall St, Kankakee, IL 60901-2901 | 2020-05-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558978841 | William Mitsos Dds | Dentist | 1291 S. 7th Ave, Kankakee, IL 60901 | 2020-09-30 |
| 1922653682 | Jody Mcguyer, Lcpc, Cadc Counseling Services, LLC | Counselor | 315 W. Court St., Kankakee, IL 60901 | 2019-08-08 |
| 1700346327 | Sarah Elizabeth Toma | Speech-Language Pathologist | 200 E Court St #708, Kankakee, IL 60901 | 2019-03-20 |
| 1710473160 | Small Talk Speech Services, LLC | Clinic/Center | 1439 W Vanmeter St, Kankakee, IL 60901 | 2018-07-09 |
| 1124538004 | Amy J Green | Physical Therapist | 350 N. Wall Street, Kankakee, IL 60901 | 2017-10-05 |
| 1013457514 | Elizabeth Ann Smith | Registered Nurse | 292 Charlton Lane, Kankakee, IL 60901 | 2017-03-02 |
| 1861931461 | Stacey E. Brown | Nurse Practitioner | 207 N. Schuyler Ave., Kankakee, IL 60901 | 2017-02-15 |
| 1417352105 | Provider Healthcare Services, Inc | Home Health | 555 South Schuyler, Suite 275, Kankakee, IL 60901 | 2014-10-24 |
| 1265850655 | Ronald George Testa | Dentist | 202 N. Schuyler Ave, Kankakee, IL 60901 | 2014-04-02 |
| 1245587898 | Mary Beth Wertz | Registered Nurse | 100 N Jeffery Street, Kankakee, IL 60901 | 2012-08-13 |
| Find all providers in zip 60901 | ||||
| Taxonomy Code | 276400000X |
| Grouping | Hospital Units |
| Classification | Rehabilitation, Substance Use Disorder Unit |
| 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.) |
| Notes: Source: Department of Defense Regulation 6010.8-R, Chapter 6. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619460326 | Safer Foundation | Rehabilitation, Substance Use Disorder Unit | 808 S Kedzie Ave, Chicago, IL 60612-3929 | 2018-06-08 |
| 1891286266 | International Word Out Ministries | Rehabilitation, Substance Use Disorder Unit | 1139 W Vermont Ave, Calumet Park, IL 60827-6520 | 2018-05-22 |
| 1962877332 | Salud Dental LLC | Rehabilitation, Substance Use Disorder Unit | 334 S. Neltnor Blvd Unit # G, West Chicago, IL 60185 | 2015-12-10 |
| 1083884019 | Bridging The Tys To Jordan Inc | Rehabilitation, Substance Use Disorder Unit | 7122 S Vincennes Ave, Suite B, Chicago, IL 60621-2661 | 2008-03-05 |
| 1992973689 | Specialized Assistance Services, Nfp | Rehabilitation, Substance Use Disorder Unit | 2630 S. Wabash, Chicago, IL 60616 | 2008-02-14 |
| 1356955744 | Solutions Counseling and Consulting Group | Rehabilitation, Substance Use Disorder Unit | 11740 S Western Ave, Chicago, IL 60643-4732 | 2020-09-02 |
| 1982212205 | Steppin Stone Inc | Rehabilitation, Substance Use Disorder Unit | 7244 W Benton Dr, Frankfort, IL 60423-9303 | 2020-07-22 |
| 1770144925 | Association for Individual Development | Rehabilitation, Substance Use Disorder Unit | 1230 N Highland Ave, Aurora, IL 60506-1401 | 2019-06-27 |
| 1104301688 | Family Counseling Service of Aurora | Rehabilitation, Substance Use Disorder Unit | 84 Templeton Dr, Oswego, IL 60543-7008 | 2018-10-01 |
| 1285151704 | Safer Foundation | Rehabilitation, Substance Use Disorder Unit | 3210 W Arthington St, Chicago, IL 60624-4121 | 2017-08-25 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.