Organization
VILLAGE OF RIVERSIDE
Active
Other names
Riverside Fire Department
Organization subpart
No
Provider details
NPI number
Authorized official
KARIN S JOHNS (FINANCE DIRECTOR)
(708) 447-2700
Entity
Organization
Contact information
Practice address
27 RIVERSIDE RD, RIVERSIDE, IL 60546-2278
(708) 447-2123
(708) 442-4382
Mailing address
1 PIERCE PL STE 750W, ITASCA, IL 60143-1234
(847) 678-0865
(847) 678-0865
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
8078
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1619798
BCBS
IL
01
—
590008278
RR MEDICARE
IL
Enumeration date
06/14/2006
Last updated
08/10/2023
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