Organization Active NPI

Riverside Medical, S.C.

  • Internal Medicine Physician
  • Arlington Heights, IL
National Provider Identifier
1295918795
Registry record updated Dec 7, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
RIVERSIDE MEDICAL, S.C.
Practice address
3405 N Arlington Heights Rd
Arlington Heights, IL 60004-1536
Phone
(847) 577-9300
Fax
(847) 577-9318
NPI assigned
Dec 7, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2007

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

Authorized official

Name
Ms. Monica Marie Esparza
Title
Business Office Manager
Phone
(847) 577-9300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X IL Primary

Addresses

Primary practice location

3405 N Arlington Heights Rd
Arlington Heights, IL 60004-1536

Mailing address

3405 N Arlington Heights Rd
Arlington Heights, IL 60004-1536
Phone (847) 577-9300

Other identifiers 2

IdentifierTypeStateIssuer
1616210OtherILBCBS GROUP
648500OtherILMEDICAREGROUP

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040310000179 IL Part B Supplier - Clinic/Group Practice 4688562606 Receives reassigned benefits from 17 practitioners
Practice locations: Arlington Heights, IL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
14D0411499Riverside Medical SC3405 N Arlington Heights Rd, Arlington Heights, IL 60004Certificate of waiverAug 27, 2026

National Provider Directory

National Provider Directory

Locations

3405 N Arlington Heights Rd
#R
Arlington Heights, IL 60004
Phone (312) 577-9300

3411 N Arlington Heights Rd
Arlington Heights, IL 60004

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1196985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196985600000",
    "number": "1295918795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3405 N ARLINGTON HEIGHTS RD",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600041536",
            "telephone_number": "847-577-9300",
            "fax_number": "847-577-9318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3405 N ARLINGTON HEIGHTS RD",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600041536",
            "telephone_number": "847-577-9300",
            "fax_number": "847-577-9318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVERSIDE MEDICAL, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-07",
        "last_updated": "2007-12-07",
        "status": "A",
        "authorized_official_last_name": "ESPARZA",
        "authorized_official_first_name": "MONICA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "BUSINESS OFFICE MANAGER",
        "authorized_official_telephone_number": "847-577-9300",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP",
            "identifier": "1616210",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAREGROUP",
            "identifier": "648500",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington Heights, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.