# RIVERSIDE MEDICAL CENTER

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** RIVERSIDE MEDICAL CENTER
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1740346451
- **Legal business name:** RIVERSIDE MEDICAL CENTER
- **Authorized official:** MR. BILL DOUGLAS (CFO)
- **Authorized official phone:** (815) 935-7256

## Contact information

- **Practice address:** 611 DIVISION STREET, PEOTONE, IL 60468-9590
- **Practice address phone:** (815) 935-3272
- **Practice address fax:** (815) 937-7961
- **Mailing address:** 350 N WALL ST, KANKAKEE, IL 60901-2901
- **Mailing address phone:** (815) 933-1671

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | 1001668 | IL | Yes |

## Other

- **Enumeration date:** 12/28/2006
- **Last updated:** 09/30/2019