Healthcare Provider Details

I. General information

NPI: 1134577794
Provider Name (Legal Business Name): CITY OF ALTON ILL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/24/2016
Last Update Date: 08/27/2025
Certification Date: 08/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 E 20TH ST
ALTON IL
62002-6816
US

IV. Provider business mailing address

PO BOX 457
WHEELING IL
60090-0457
US

V. Phone/Fax

Practice location:
  • Phone: 618-463-3565
  • Fax: 336-791-0196
Mailing address:
  • Phone: 800-244-2345
  • Fax: 336-791-0196

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number044120
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State

VIII. Authorized Official

Name: DEBRA KAY DUNLAP
Title or Position: COMPTROLLER
Credential:
Phone: 618-463-3550