Provider Demographics
NPI:1871334383
Name:RIVERONE HEALTH & WELLNESS LLC
Entity type:Organization
Organization Name:RIVERONE HEALTH & WELLNESS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HA-IL
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:DC, COF
Authorized Official - Phone:815-705-6246
Mailing Address - Street 1:333 N HAMMES AVE STE 107
Mailing Address - Street 2:
Mailing Address - City:JOLIET
Mailing Address - State:IL
Mailing Address - Zip Code:60435-8119
Mailing Address - Country:US
Mailing Address - Phone:815-705-6246
Mailing Address - Fax:855-641-2321
Practice Address - Street 1:333 N HAMMES AVE STE 107
Practice Address - Street 2:
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60435-8119
Practice Address - Country:US
Practice Address - Phone:815-705-6246
Practice Address - Fax:855-641-2321
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RIVERONE HEALTH & WELLNESS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-06-06
Last Update Date:2024-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies