Organization
RIVERSIDE MEDICAL CENTER
Active
Parent organization
RIVERSIDE MEDICAL CENTER
Other names
Riverside Specialty Pharmacy
Organization subpart
Yes
Provider details
NPI number
Legal business name
RIVERSIDE MEDICAL CENTER
Authorized official
PATRICIA KIM VILT (CFO)
(815) 450-7754
Entity
Organization
Contact information
Practice address
100 FITNESS DR, BOURBONNAIS, IL 60914-9584
(815) 634-5225
(779) 701-2280
Mailing address
350 N WALL ST, KANKAKEE, IL 60901-2991
(815) 935-7256
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Enumeration date
12/28/2022
Last updated
12/28/2022
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