Renato Bacol Rivera, M.D.
Surgery Physician · Breese, IL
Practice location
9515 Holy Cross Ln Ste 175Breese, IL 62230-3618
- Phone
- (618) 526-8430
- Fax
- (618) 526-7275
NPI record
- NPI
- 1083612790
- Entity type
- Individual (Type 1)
- Enumeration date
- July 7, 2005
- Last updated
- December 30, 2021
- Certified
- December 30, 2021
- Sole proprietor
- No
Specialties & taxonomy codes
| Taxonomy | Code | License | State |
|---|---|---|---|
| Surgery Physician Primary | 208600000X |
036045712 | IL |
Mailing address
9401 Holy Cross LnSuite 111
Breese, IL 62230-3510
- Phone
- (618) 526-7133
- Fax
- (618) 526-7160
About Dr. Rivera
Renato Bacol Rivera, M.D. is a healthcare provider registered in the NPI registry with the primary taxonomy Surgery Physician (code 208600000X). The practice location is 9515 Holy Cross Ln Ste 175, Breese, IL 62230-3618. The NPI number 1083612790 was assigned on July 7, 2005 and the record was last updated on December 30, 2021.
Dr. Rivera lists a license in the registry: #036045712 (IL) for Surgery Physician. License numbers are self-reported to NPPES; verify them with the state licensing board.
Frequently asked questions
What is the NPI number of Renato Bacol Rivera, M.D.?
The NPI number is 1083612790.
What is the phone number of Dr. Rivera?
The phone number listed for the practice location is (618) 526-8430.
Where is Dr. Rivera located?
9515 Holy Cross Ln Ste 175, Breese, IL 62230-3618.
What is the taxonomy code for Dr. Rivera?
The primary taxonomy code is 208600000X – Surgery Physician.
Is this information correct?
All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.
Other Surgery Physician providers in Breese
- Osman Salih Mahdi Babikir, M.D.9515 Holy Cross Ln Ste 175
- Ulunna Kechinyere Macbean, M.D9515 Holy Cross Ln Ste 175