Healthcare Provider Details

I. General information

NPI: 1639174006
Provider Name (Legal Business Name): VILLAGE OF LINCOLNWOOD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/14/2005
Last Update Date: 07/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6900 N. LINCOLN
LINCOLNWOOD IL
60712
US

IV. Provider business mailing address

6900 N. LINCOLN AVE.
LINCOLNWOOD IL
60712
US

V. Phone/Fax

Practice location:
  • Phone: 847-673-1545
  • Fax: 847-673-7456
Mailing address:
  • Phone: 847-673-1545
  • Fax: 847-673-7456

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number
License Number State

VIII. Authorized Official

Name: MRS. KAREN KUTCHER
Title or Position: FIRE DEPARTMENT COORDINATOR
Credential:
Phone: 847-673-1545