Healthcare Provider Details

I. General information

NPI: 1285677468
Provider Name (Legal Business Name): VILLAGE OF ROMEOVILLE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/14/2006
Last Update Date: 04/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18 MONTROSE DR
ROMEOVILLE IL
60446-1370
US

IV. Provider business mailing address

18 MONTROSE DR
ROMEOVILLE IL
60446-1370
US

V. Phone/Fax

Practice location:
  • Phone: 815-886-7231
  • Fax: 815-886-3546
Mailing address:
  • Phone: 815-886-7231
  • Fax: 815-886-3546

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number7102
License Number StateIL

VIII. Authorized Official

Name: KENT ADAMS
Title or Position: FIRE CHIEF
Credential:
Phone: 815-886-7231