Organization
RIVEREDGE HOSPITAL, INC.
Active
Other names
Riveredge Outpatient Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
STEVE FILTON (SR VP/CFO)
(610) 768-3300
Entity
Organization
Contact information
Practice address
8311 ROOSEVELT RD, FOREST PARK, IL 60130-2529
(708) 771-7000
Mailing address
8311 ROOSEVELT RD, FOREST PARK, IL 60130-2529
(708) 771-7000
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
0005124
IL
103TB0200X
Cognitive & Behavioral Psychologist
0005124
IL
103TC0700X
Clinical Psychologist
0005124
IL
103TC1900X
Counseling Psychologist
0005124
IL
103TC2200X
Clinical Child & Adolescent Psychologist
0005124
IL
103TF0000X
Family Psychologist
0005124
IL
103TP0016X
Prescribing (Medical) Psychologist
0005124
IL
103TP2701X
Group Psychotherapy Psychologist
0005124
IL
2084N0600X
Clinical Neurophysiology Physician
0005124
IL
2084P0800X
Psychiatry Physician
0005124
IL
2084P0804X
Child & Adolescent Psychiatry Physician
0005154
IL
283Q00000X
Psychiatric Hospital
Primary
0005124
IL
Other
Enumeration date
04/13/2016
Last updated
04/13/2016
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