NPI 1497875298

Cook County

Organisation Primary Care Clinic/Center Riverside, IL

Practice location

Address: 1800 S. Harlem Ave, Riverside, IL 60546-1468
Phone: (708) 783-9800
Mailing address: 1900 W Polk St Rm 220c, Chicago, IL 60612-3723

Authorised official

Name: Scott Andrle
Title: Director of Managed Care Operatons
Phone: (312) 864-4649

Registered specialties

Primary Care Clinic/Center Primary

Ambulatory Health Care Facilities Taxonomy 261QP2300X Licence 0005272 (IL)

Other Clinic/Center providers in Illinois →

Registry record

NPI: 1497875298
Entity type: Organization
NPI issued: 29 Mar 2007
Record last updated: 13 Feb 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.