Healthcare Provider Details

I. General information

NPI: 1952573578
Provider Name (Legal Business Name): VILLAGE OF SAUK VILLAGE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/25/2008
Last Update Date: 09/19/2023
Certification Date: 09/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21701 TORRENCE AVE
SAUK VILLAGE IL
60411-4561
US

IV. Provider business mailing address

PO BOX 457
WHEELING IL
60090-0457
US

V. Phone/Fax

Practice location:
  • Phone: 708-758-2225
  • Fax: 708-753-0901
Mailing address:
  • Phone: 847-577-8811
  • Fax: 847-577-3518

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333300000X
TaxonomyEmergency Response System Companies
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State

VIII. Authorized Official

Name: CHRISTOPHER SEWELL
Title or Position: CHIEF
Credential:
Phone: 708-758-2225