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General NPI Number Information
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NPI Number | 1639445877
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Entity Type | Individual
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Provider Name | JOSEPH R RIVAS MD, PC
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Gender | Male
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Dates
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Enumeration Date | 03/30/2012
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Last Update Date | 03/30/2012
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Provider Practice Location Address
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Address Line | 511 W BELMONT AVE #32
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City | CHICAGO
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State | IL
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Zip | 60657-4663
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Country | US
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Telephone | 630-881-1148
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Fax |
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Provider Business Mailing Address
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Address Line | 511 W BELMONT AVE #32
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City | CHICAGO
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State | IL
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Zip | 60657-4663
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Country | US
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Telephone | 630-881-1148
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number | C43254
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number | MD.09654R
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License Number State | LA
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Taxonomy #3
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number | 8113
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License Number State | PR
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Taxonomy #4
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number | 141769
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License Number State | NY
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Taxonomy #5
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number | MD 028112 E
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License Number State | PA
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Taxonomy #6
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number | 86/0431
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License Number State | ZZ
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