Healthcare Provider Details

I. General information

NPI: 1497819684
Provider Name (Legal Business Name): CITY OF DESPLAINES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/21/2006
Last Update Date: 03/19/2026
Certification Date: 03/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

405 S RIVER RD
DES PLAINES IL
60016-4730
US

IV. Provider business mailing address

405 S RIVER RD
DES PLAINES IL
60016-4730
US

V. Phone/Fax

Practice location:
  • Phone: 773-233-1170
  • Fax: 773-233-8146
Mailing address:
  • Phone: 773-233-1170
  • Fax: 773-233-8146

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number818001
License Number StateIL

VIII. Authorized Official

Name: MR. MATTHEW MATZL
Title or Position: FIRE CHIEF
Credential:
Phone: 773-233-1170