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PEMBROKE COMMUNITY HEALTH CENTER
NPI 1982703005
Family Medicine in Hopkins Park, IL

Active since September 22, 2006CLIA 14D0646704 · Waiver
3400 S MAIN ST., HOPKINS PARK, IL 60944(815) 944-5545(815) 944-6723 Get Directions Write a Review

NPPES record last updated: March 29, 2024. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Pembroke Community Health Center NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PEMBROKE COMMUNITY HEALTH CENTER (NPI 1982703005) is a healthcare organization registered as a family medicine in Hopkins Park, Illinois and active in the NPI registry since September 2006. The organization holds a CLIA Waiver certificate valid through April 17, 2027 and lists Patricia K Vilt, Cfo, as its authorized official.

NPPES Registry Identity

NPI1982703005
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameRIVERSIDE MEDICAL CENTER
Location Address3400 S MAIN ST.Hopkins Park, IL 60944-9998
Mailing AddressPo Box 781Kankakee, IL 60901-0781 · (815) 935-7256 · Fax (815) 935-7864
Phone(815) 944-5545
Fax(815) 944-6723
Organization SubpartYes
Authorized OfficialPatricia K ViltCfo · (815) 933-1671
Enumeration DateSeptember 22, 2006
Last NPPES UpdateMarch 29, 2024
NPPES CertifiedMarch 29, 2024
✔ NPI 1982703005 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in IL · 007
Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Also ListedClinic/Center · Rural HealthTaxonomy 261QR1300X
3400 S MAIN ST., Hopkins Park, IL 60944
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Other Names 1

Doing Business AsPembroke Community Health Center

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 14D0646704

Pembroke Community Health Center · Hopkins Park, IL
Active · expires Apr 17, 2027
CLIA Number14D0646704
Laboratory TypePhysician Office
Certificate Effective DateApril 18, 2025
Certificate Expiration DateApril 17, 2027
Laboratory DirectorStonewall Mccuiston
Laboratory Phone(815) 944-5545
Laboratory LocationPembroke Community Health Center3400 S Main St, Hopkins Park, IL 60944
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions

What is RIVERSIDE MEDICAL CENTER's NPI number?

The NPI number assigned to this healthcare provider is 1982703005, enumerated as an "organization" on September 22, 2006.

Where is the provider located?

The provider is located at 3400 S MAIN ST. HOPKINS PARK, IL 60944 and the phone number is (815) 944-5545.

What is the provider's specialty?

Family Medicine with taxonomy code 207Q00000X.