NPIMap

Organization Active NPI

Riverside Medical Center

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Bradley, IL
National Provider Identifier
1225843113
Registry record updated Feb 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
RIVERSIDE MEDICAL CENTER
Practice address
400 S Kennedy Dr
Bradley, IL 60915-2682
Phone
(815) 935-7256
NPI assigned
Feb 10, 2025
Last updated
Feb 10, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
RIVERSIDE MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 10, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Patricia Kim Vilt
Title
Senior Vice President and Cfo
Phone
(815) 935-7542

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X NU Primary
Substance Use Disorder Rehabilitation Hospital Unit 276400000X NU

Addresses

Primary practice location

400 S Kennedy Dr
Bradley, IL 60915-2682

Mailing address

350 N Wall St
Kankakee, IL 60901-2901

National Provider Directory

National Provider Directory
Tax ID family
Riverside Med Ctr RR13 organizations share this tax ID, including this one
Part of
Riverside Med Ctr RR

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1739145600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739145600000",
    "number": "1225843113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 N WALL ST",
            "city": "KANKAKEE",
            "state": "IL",
            "postal_code": "609012901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 S KENNEDY DR",
            "city": "BRADLEY",
            "state": "IL",
            "postal_code": "609152682",
            "telephone_number": "815-935-7256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVERSIDE MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RIVERSIDE MEDICAL CENTER",
        "enumeration_date": "2025-02-10",
        "last_updated": "2025-02-10",
        "certification_date": "2025-02-10",
        "status": "A",
        "authorized_official_last_name": "VILT",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_middle_name": "KIM",
        "authorized_official_title_or_position": "SENIOR VICE PRESIDENT AND CFO",
        "authorized_official_telephone_number": "815-935-7542"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "276400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation, Substance Use Disorder Unit",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradley, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.