Healthcare Provider Details

I. General information

NPI: 1144395864
Provider Name (Legal Business Name): CITY OF CHICAGO HEIGHTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/21/2006
Last Update Date: 09/05/2025
Certification Date: 09/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

83 E JOE ORR RD
CHICAGO HEIGHTS IL
60411-1223
US

IV. Provider business mailing address

PO BOX 6253
CAROL STREAM IL
60197-6253
US

V. Phone/Fax

Practice location:
  • Phone: 708-756-5370
  • Fax: 708-756-5358
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 Number78153
License Number StateIL

VIII. Authorized Official

Name: DAVID A GONZALEZ
Title or Position: MAYOR
Credential:
Phone: 708-656-3600