Physician Compare National (NPI:1184817918)

HEALTHCARE PROVIDER: DAVID RIOS MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1184817918
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	8921193657
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20070926000846
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	RIOS
	Individual professional last name
Provider First Name	DAVID
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	2004
	Individual professional's medical school graduation year
Primary Specialty	EMERGENCY MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	STATERA HEALTH CARE LLC
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	0244565729
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	6
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	100 DR WARREN TUTTLE DR
	Group Practice or individual's line 1 address
City	HARRISBURG
	Group Practice or individual's city
State	IL
	Group Practice or individual's state
Zip Code	629462718
	Group Practice or individual's zip code (9 digits when available)
Phone Number	6182537671
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	150065
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	SCHNECK MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	141326
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	HAMILTON MEMORIAL HOSPITAL DISTRICT
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	440065
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	NORTHCREST MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	140210
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	HARRISBURG MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 4
Hospital Affiliation CCN 5	140294
	Medicare CCN of hospital where individual professional provides service 5
Hospital Affiliation LBN 5	CROSSROADS COMMUNITY HOSPITAL
	Legal business name of hospital where individual professional provides service 5
Professional Accepts Medicare Assignment	Y

Physician Compare National (NPI:1184817918)

HEALTHCARE PROVIDER: DAVID RIOS MD

Individual Professional Information

Medical School Information

Practice Information

Hospital(s) Affiliation Information