MEDICARE: VILLAGE OF MELROSE PARK

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	341600000X	Ambulance	88070	IL

General Provider Information

NPI Number	:	1588656912
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VILLAGE OF MELROSE PARK

Provider Business Mailing Address
First Line	:	PO BOX 1225
Second Line	:
City	:	MELROSE PARK
State	:	IL
Zip	:	60161-1225
Country	:	US
Telephone Number	:	708-344-5880
Fax Number	:	708-344-3183

Provider Business Practice Location Address
First Line	:	3601 W LAKE ST
Second Line	:
City	:	MELROSE PARK
State	:	IL
Zip	:	60160-2705
Country	:	US
Telephone Number	:	708-344-1210
Fax Number	:	708-344-5304

Authorized Official
Title or Position	:	FIRE CHIEF
Name	:	RICHARD A BELTRAME JR.
Credential	:
Telephone Number	:	708-344-1315

Provider Enumeration Date	:	08/22/2005
Last Update Date	:	08/22/2020

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Directions to “VILLAGE OF MELROSE PARK ” Practice Location

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