Healthcare Provider Details

I. General information

NPI: 1316005978
Provider Name (Legal Business Name): CITY OF JANESVILLE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2006
Last Update Date: 09/19/2023
Certification Date: 09/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18 N JACKSON ST
JANESVILLE WI
53548
US

IV. Provider business mailing address

PO BOX 457
WHEELING IL
60090-0457
US

V. Phone/Fax

Practice location:
  • Phone: 608-755-3000
  • Fax: 608-755-3196
Mailing address:
  • Phone: 847-577-8811
  • Fax: 800-329-5274

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State

VIII. Authorized Official

Name: LORENA RAE STOTTLER
Title or Position: CLERK-TREASURER
Credential:
Phone: 608-755-3072