Healthcare Provider Details

I. General information

NPI: 1255775839
Provider Name (Legal Business Name): RIVERWOOD REHAB, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2013
Last Update Date: 09/10/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8131 MONTICELLO AVE
SKOKIE IL
60076-3325
US

IV. Provider business mailing address

430 30TH AVE
EAST MOLINE IL
61244-3152
US

V. Phone/Fax

Practice location:
  • Phone: 847-673-6767
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: YOSEF MEYSTEL
Title or Position: MANAGER
Credential:
Phone: 847-673-6767