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Organization
RIVERSIDE AMBULATORY SURGERY CENTER, LLC
Active
Organization
RIVERSIDE AMBULATORY SURGERY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TERESA BOCKOVER RN (CLINICAL DIRECTOR)
(815) 802-3170
Entity
Organization
Contact information
Practice address
300 RIVERSIDE DR STE 1100, BOURBONNAIS, IL 60914-4997
(815) 802-3170
Mailing address
300 RIVERSIDE DR STE 1100, BOURBONNAIS, IL 60914-4997
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
7003049
IL
Other
Enumeration date
08/21/2006
Last updated
08/22/2020
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