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Organization

RIVER DISTRICT REHABILITATION, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. EDWIN BATIFORA DISTRITO (OWNER)
(815) 885-2820
Entity
Organization

Contact information

Practice address
119 N WYMAN ST, ROCKFORD, IL 61101-1107
(815) 977-4490
(815) 977-4594
Mailing address
12402 TWEED DR, LOVES PARK, IL 61111-8959
(815) 885-2820
(815) 977-4594

Taxonomy

Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
1990943
IL

Other

Enumeration date
11/20/2009
Last updated
11/20/2009
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