Healthcare Provider Details

I. General information

NPI: 1073551990
Provider Name (Legal Business Name): VILLAGE OF BERKELEY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2006
Last Update Date: 09/05/2025
Certification Date: 09/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5819 ELECTRIC AVE
BERKELEY IL
60163-1522
US

IV. Provider business mailing address

PO BOX 6253
CAROL STREAM IL
60197-6253
US

V. Phone/Fax

Practice location:
  • Phone: 708-449-9444
  • Fax: 708-449-6189
Mailing address:
  • Phone: 630-630-2988
  • Fax: 630-832-9750

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number88918
License Number StateIL

VIII. Authorized Official

Name: TIMOTHY LAREM
Title or Position: PUBLIC SAFETY DIRECTOR
Credential:
Phone: 708-234-2627