Healthcare Provider Details

I. General information

NPI: 1265548002
Provider Name (Legal Business Name): VILLAGE OF BELLWOOD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2006
Last Update Date: 09/05/2025
Certification Date: 09/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3200 WASHINGTON BLVD
BELLWOOD IL
60104-1950
US

IV. Provider business mailing address

PO BOX 1368
ELMHURST IL
60126-8368
US

V. Phone/Fax

Practice location:
  • Phone: 708-547-3524
  • Fax: 708-547-9552
Mailing address:
  • Phone: 630-530-2988
  • Fax: 630-832-9750

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number88060
License Number StateIL

VIII. Authorized Official

Name: MR. ANDRE HARVEY
Title or Position: MAYOR
Credential:
Phone: 708-547-3524