Healthcare Provider Details

I. General information

NPI: 1376554592
Provider Name (Legal Business Name): CITY OF CHICAGO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2006
Last Update Date: 02/20/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 N. LASALLE ROOM 107A
CHICAGO IL
60602-1288
US

IV. Provider business mailing address

33589 TREASURY CTR
CHICAGO IL
60694-3500
US

V. Phone/Fax

Practice location:
  • Phone: 312-742-7065
  • Fax: 312-744-4792
Mailing address:
  • Phone: 312-742-7065
  • Fax: 312-744-4792

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code146L00000X
TaxonomyParamedic
License Number118700
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code146N00000X
TaxonomyBasic Emergency Medical Technician
License Number118701
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code341600000X
TaxonomyAmbulance
License Number000008700
License Number StateIL
# 4
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number
License Number State

VIII. Authorized Official

Name: MR. JOEL FLORES
Title or Position: DEPUTY DIRECTOR
Credential:
Phone: 312-744-4002