Organization
RIVERVIEW OB-GYN, LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RENUKA RAMAKRISHNA MD (PRESIDENT)
(815) 933-2231
Entity
Organization
Contact information
Practice address
400 N WALL ST, SUITE 403, KANKAKEE, IL 60901-2940
(815) 933-2231
(815) 933-2297
Mailing address
400 N WALL ST, SUITE 403, KANKAKEE, IL 60901-2940
(815) 933-2231
(815) 933-2297
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14D0429316
CLIA
IL
01
—
4615066
BCBS
IL
Enumeration date
07/10/2006
Last updated
03/19/2009
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