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Organization

JAMES J. DALLA RIVA, MD, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JAMES J DALLA RIVA MD (PRESIDENT)
(618) 288-5699
Entity
Organization

Contact information

Practice address
6810 STATE ROUTE 162, SUITE 301, MARYVILLE, IL 62062-8501
(618) 288-5699
(618) 288-5797
Mailing address
6810 STATE ROUTE 162, SUITE 301, MARYVILLE, IL 62062-8501
(618) 288-5699
(618) 288-5797

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0360879061
IL
Enumeration date
01/11/2008
Last updated
05/10/2024
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