Healthcare Provider Details

I. General information

NPI: 1922057108
Provider Name (Legal Business Name): VILLAGE OF ROSELLE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2006
Last Update Date: 09/08/2025
Certification Date: 09/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31 S PROSPECT ST
ROSELLE IL
60172-2023
US

IV. Provider business mailing address

PO BOX 6253
CAROL STREAM IL
60197-6253
US

V. Phone/Fax

Practice location:
  • Phone: 630-671-2844
  • Fax: 630-655-1875
Mailing address:
  • Phone: 630-530-2988
  • Fax: 630-832-9750

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number97281
License Number StateIL

VIII. Authorized Official

Name: THOMAS DAHL
Title or Position: FINANCE DIRECTOR
Credential:
Phone: 630-671-2830