Healthcare Provider Details

I. General information

NPI: 1447432208
Provider Name (Legal Business Name): RIVERPOINT PEDIATRICS, S.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/03/2007
Last Update Date: 12/03/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2435 N ASHLAND AVE
CHICAGO IL
60614-2032
US

IV. Provider business mailing address

2435 N ASHLAND AVE
CHICAGO IL
60614-2032
US

V. Phone/Fax

Practice location:
  • Phone: 773-929-4343
  • Fax: 773-929-9184
Mailing address:
  • Phone: 773-929-4343
  • Fax: 773-929-9184

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number StateIL

VIII. Authorized Official

Name: ARMAND A GONZALZLES
Title or Position: PRESIDENT
Credential: M.D.
Phone: 773-929-4343