Healthcare Provider Details

I. General information

NPI: 1083615728
Provider Name (Legal Business Name): VILLAGE OF CLARENDON HILLS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2005
Last Update Date: 09/05/2025
Certification Date: 09/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 N POSPECT AVE
CLARENDON HILLS IL
60514
US

IV. Provider business mailing address

1 N POSPECT AVE
CLARENDON HILLS IL
60514
US

V. Phone/Fax

Practice location:
  • Phone: 630-323-3530
  • Fax: 630-323-3512
Mailing address:
  • Phone: 630-323-3500
  • Fax: 630-323-3512

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number000721001
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code3416A0800X
TaxonomyAir Ambulance
License Number
License Number State

VIII. Authorized Official

Name: MAUREEN B POTEMPA
Title or Position: FINANCE DIRECTOR
Credential:
Phone: 630-286-5415