RIVERSIDE MEDICAL CENTER (NPI# 1982093837) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982093837 |
| 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 | 2015-01-15 |
| Last Update Date | 2015-01-15 |
| 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 |
|---|---|---|---|---|---|
| Y | 273R00000X | Psychiatric Unit | 0002014 | IL | Hospital Units |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | DEPARTMENT OF LABOR | 366869400 | 01 |
| IL | HOSPITAL NPI | 1538208210 | 01 |
| IL | BLUE CROSS | 360 | 01 |
| IL | BLACK LUNG | 026741200 | 01 |
| IL | TRICARE | L006923 | 01 |
| 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 | 273R00000X |
| Grouping | Hospital Units |
| Classification | Psychiatric Unit |
| In general, a distinct unit of a hospital that provides acute or long-term care to emotionally disturbed patients, including patients admitted for diagnosis and those admitted for treatment of psychiatric problems on the basis of physicians' orders and approved nursing care plans. Long-term care may include intensive supervision to the chronically mentally ill, mentally disordered or other mentally incompetent persons; (2) For Medicare, a distinct part of a general acute care hospital admitting only patients whose admission to the unit is required for active treatment, whose treatment is of an intensity that can be provided only in an inpatient hospital setting, and whose condition is described by a psychiatric principal diagnosis contained in the Third Edition of the American Psychiatric Association Diagnostic and Statistical Manual or in Chapter 5 (Mental Disorders) of the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). The unit must furnish, through the use of qualified personnel, psychological services, social work services, psychiatric nursing, occupational therapy, and recreational therapy. The unit must maintain medical records that permit determination of the degree and intensity of treatment provided to individuals who are furnished services in the unit; the unit must meet special staff requirements in that the unit must have adequate numbers of qualified professional and supportive staff to evaluate inpatients, formulate written, individualized, comprehensive treatment plans, provide active treatment measures and engage in discharge planning. |
| Notes: Source: (1) AHA Annual Survey p. A10 1996 AHA Guide; (2) Code of Federal Regulations #42, Section 412.27. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639657414 | Advocate North Side Health Network | Psychiatric Unit | 836 W Wellington Ave., Chicago, IL 60657 | 2018-08-02 |
| 1427547538 | Holy Cross Hospital | Psychiatric Unit | 2701 West 68th Street, Chicago, IL 60629 | 2018-05-03 |
| 1740570316 | Robert Young Center | Psychiatric Unit | 4200 6th Ave, Rock Island, IL 61201-2109 | 2011-04-15 |
| 1669704326 | Isaac Ray Center At Cermak | Psychiatric Unit | 3159 N Seminary #301, Chicago, IL 60657 | 2010-02-05 |
| 1316115223 | 394567 D North | Psychiatric Unit | 4200 North Oak Park Ave, Chicago, IL 60634-1417 | 2008-02-13 |
| 1508034414 | 395061 Med Eval | Psychiatric Unit | 4200 North Oak Park Avenue, Chicago, IL 60634-1417 | 2008-02-13 |
| 1952425076 | Elgin Mental Health Center William White 4585 | Psychiatric Unit | 750 S. State St., Elgin, IL 60123-7692 | 2007-03-16 |
| 1932251766 | Families and Adolescents In Recovery, Inc. | Psychiatric Unit | 2010 E Algonquin Rd, Suite # 203-207, Schaumburg, IL 60173-4185 | 2007-01-18 |
| 1003976713 | Presence Central and Suburban Hospitals Network | Psychiatric Unit | 333 N. Madison St., Joliet, IL 60435-6595 | 2006-12-11 |
| 1871678334 | Kindred Thc Chicago, LLC | Psychiatric Unit | 2544 W Montrose Ave, Chicago, IL 60618 | 2006-10-25 |
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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.