# RIVERSIDE MEDICAL CENTER

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1538208210
- **Authorized official:** MR. BILL W DOUGLAS (VICE PRESIDENT AND CFO)
- **Authorized official phone:** (815) 935-7256

## Contact information

- **Practice address:** 350 N WALL ST, KANKAKEE, IL 60901-2901
- **Practice address phone:** (815) 935-7256
- **Practice address fax:** (815) 935-7490
- **Mailing address:** 350 N WALL ST, KANKAKEE, IL 60901-2901
- **Mailing address phone:** (815) 935-7256
- **Mailing address fax:** (815) 935-7490

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 273R00000X | Psychiatric Hospital Unit | 0002014 | IL | — |
| 273Y00000X | Rehabilitation Hospital Unit | 0002014 | IL | — |
| 282N00000X | General Acute Care Hospital | 0002014 | IL | Yes |

## Other

- **Enumeration date:** 02/06/2007
- **Last updated:** 12/18/2009