| Riverside Medical Center | |
|
350 N Wall St Kankakee IL 60901-2901 | |
| (815) 935-7256 | |
| (815) 935-7490 |
| Full Name | Riverside Medical Center |
|---|---|
| Speciality | General Acute Care Hospital |
| Location | 350 N Wall St, Kankakee, Illinois |
| Authorized Official Name and Position | Bill W Douglas (VICE PRESIDENT AND CFO) |
| Authorized Official Contact | 8159357256 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Riverside Medical Center 350 N Wall St Kankakee IL 60901-2901 Ph: (815) 935-7256 | Riverside Medical Center 350 N Wall St Kankakee IL 60901-2901 Ph: (815) 935-7256 |
| NPI Number | 1538208210 |
|---|---|
| Provider Enumeration Date | 02/06/2007 |
| Last Update Date | 12/18/2009 |
| Medicare PECOS PAC ID | 5991608549 |
|---|---|
| Medicare Enrollment ID | O20090929000499 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538208210 | NPI | - | NPPES |
| 01706 | Medicaid | ND | |
| 0240224 | Medicaid | OH | |
| 100508766 | Medicaid | NV | |
| 262438 | Medicaid | OR | |
| 301547 | Medicaid | MN | |
| 807562900 | Medicaid | ID | |
| 0029751 | Medicaid | NJ | |
| 0585372 | Medicaid | IA | |
| 1400186 | Medicaid | NC | |
| 200012020A | Medicaid | OK | |
| 404727815 | Medicaid | MI | |
| 410575300 | Medicaid | MN | |
| 5532100 | Medicaid | SD | |
| 000256935X | Medicaid | GA | |
| 304727806 | Medicaid | MI | |
| 360 | Other | IL | BLUE CROSS |
| 80489100 | Medicaid | WI | |
| N193210 | Medicaid | KS | |
| 01300193 | Medicaid | KY | |
| RIV0186N | Medicaid | AL | |
| 010415909 | Medicaid | MO | |
| 0132100 | Medicaid | SD | |
| 100455080A | Medicaid | KS | |
| 140156B000000 | Other | IL | SECTION 1011 |
| 1826 | Other | IL | RESOLVE, BLUE CROSS |
| 366869400 | Other | IL | DEPT OF LABOR ACS |
| L006923 | Other | IL | TRICARE |
| 142381601 | Medicaid | TX | |
| 3977249 | Other | IL | AETNA, RESOLVE ONLY |
| 026741200 | Other | IL | BLACK LUNG |
| 100038960A | Medicaid | IN | |
| 131841 | Other | IL | COMPSYCH |
| 159332105 | Medicaid | AR | |
| 900587100 | Medicaid | FL |
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