RIVEREDGE HOSPITAL (NPI# 1225381106) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225381106 |
| Entity Type | Organization |
| Organization Name | RIVEREDGE HOSPITAL |
| Practice Address |
8311 W Roosevelt Road Forest Park IL 60130 |
| Practice Telephone | 7087717000 |
| Practice Fax Number | 7082092292 |
| Mailing Telephone | 7087717000 |
| Mailing Fax Number | 7082092292 |
| Enumeration Date | 2012-10-17 |
| Last Update Date | 2012-10-17 |
| Authorized Official Name | MS. CAREY CARLOCK (CEO) |
| Authorized Official Telephone | 7082094182 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | RIVEREDGE HOSPITAL | 8311 W Roosevelt Rd, Forest Park, IL 60130-2529 |
| Street Address |
8311 W ROOSEVELT ROAD |
| City | FOREST PARK |
| State | IL |
| Zip Code | 60130 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740828227 | Amanda Ross | Social Worker | 1037 Desplaines Avenue, Unit 607, Forest Park, IL 60130 | 2019-12-16 |
| 1639733959 | Pop Pediatric Therapy Services, LLC | Occupational Therapy Assistant | Pop Pediatric Therapy, 7421 Madison Ave., Forest Park, IL 60130 | 2019-04-23 |
| 1194261776 | Emeryle D Ladd | Driver | 1117 S. Harlem, Unit 1, Forest Park, IL 60130 | 2017-01-06 |
| 1033479712 | Debra L Jensen | Acupuncturist | 7314 W. Madison, Forest Park, IL 60130 | 2012-05-29 |
| 1710289327 | Platinum Dental Care | Health Maintenance Organization | 333 Circle Avenue, Forest Park, IL 60130 | 2010-12-02 |
| 1174857262 | Anwar Adams | Physical Therapy Assistant | 1029 Des Plaines Ave Apt 601, Forest Park, IL 60130 | 2009-09-23 |
| 1992939318 | Family Health Solutions,pc | Chiropractor | 315 Des Plaines Ave., Suite 307, Forest Park, IL 60130 | 2009-05-13 |
| 1235386681 | Arnold Clevs | Dentist | 334 Circle Ave, Forest Park, IL 60130 | 2008-08-27 |
| 1932376167 | Dianella V Dizon-menezes | Psychiatry & Neurology | 8311 W Roosevelt Rd, Advanced Psychiatric Services, Forest Park, IL 60130 | 2008-05-16 |
| 1376727271 | Christine J Weisensee | Physical Therapy Assistant | 800 Desplaines Avenue, Forest Park, IL 60130 | 2007-12-27 |
| Find all providers in zip 60130 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
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|---|---|---|---|---|
| 1245855857 | Dragonfly Psychotherapy | Clinic/Center | 2942 Ne Orlie Dr, Forest Park, OK 73121-2436 | 2020-06-09 |
| 1033365010 | Presence Behavioral Health | Clinic/Center | 537 Des Plaines Ave, Forest Park, IL 60130-1859 | 2008-08-11 |
| 1629266473 | Clayton Mhddad | Clinic/Center | 4513 Ernest Dr, Apt. # 1 & 3, Forest Park, GA 30297-3566 | 2007-10-05 |
| 1013425081 | Self Love Solutions | Clinic/Center | 530 Forest Pkwy, Forest Park, GA 30297-2188 | 2018-01-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225639990 | Mindy Forman, Psyd, LLC | Clinic/Center | 1020 Milwaukee Ave Ste 110, Deerfield, IL 60015-3555 | 2020-11-07 |
| 1346840295 | Stopka Professional Counseling LLC | Clinic/Center | 13125 Steeplechase Dr, New Lenox, IL 60451-1320 | 2020-10-29 |
| 1346848785 | Wellness Hearted Therapy LLC | Clinic/Center | 2675 S Cedar Glen Dr, Arlington Heights, IL 60005-5303 | 2020-10-16 |
| 1457959256 | Association for Individual Development | Clinic/Center | 708 N Bridge St, Yorkville, IL 60560-1105 | 2020-10-14 |
| 1285231555 | Association for Individual Development | Clinic/Center | 236 W Crystal Lake Ave, Crystal Lake, IL 60014-5847 | 2020-10-08 |
| 1386241123 | Envision Unlimited | Clinic/Center | 1801 N Spaulding Ave, Chicago, IL 60647-4926 | 2020-10-05 |
| 1881291789 | Jessica Weisbach, LLC | Clinic/Center | 2257 N Kedzie Blvd Apt 3, Chicago, IL 60647-2561 | 2020-10-04 |
| 1619574803 | Envision Unlimited | Clinic/Center | 2124 W 82nd Pl, Chicago, IL 60620-5358 | 2020-10-01 |
| 1144827320 | Envision Unlimited | Clinic/Center | 4919 N Clark St, Chicago, IL 60640-3514 | 2020-10-01 |
| 1194322370 | Envision Unlimited | Clinic/Center | 4911 S Hoyne Ave, Chicago, IL 60609-4721 | 2020-10-01 |
| Find all providers with the same taxonomy | ||||
| City | FOREST PARK |
| Zip Code | 60130 |
Please comment or provide details below to improve the information on RIVEREDGE HOSPITAL.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.