| NPI | 1154367639 |
|---|---|
| Doing Business As | RIVERSIDE FAMILY PRACTICE |
| Entity Type | Organization |
| Authorized Contact | EDWARD TONG President 708-442-0333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036084251) |
| Enumeration Date | 2006-06-21 |
| Last Update Date | 2008-11-14 |