Healthcare Provider Details

I. General information

NPI: 1629132048
Provider Name (Legal Business Name): VILLAGE OF ALSIP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/20/2006
Last Update Date: 07/22/2025
Certification Date: 07/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12600 S PULASKI RD
ALSIP IL
60803-1913
US

IV. Provider business mailing address

PO BOX 457
WHEELING IL
60090-0457
US

V. Phone/Fax

Practice location:
  • Phone: 708-292-0134
  • Fax:
Mailing address:
  • Phone: 363-518-6343
  • Fax: 336-791-0196

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number815501
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State

VIII. Authorized Official

Name: MR. THOMAS STYCZYNSKI
Title or Position: FIRE CHIEF
Credential: PARAMEDIC
Phone: 708-292-0134