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General NPI Number Information
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NPI Number | 1104257161
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Entity Type | Organization
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Legal Business Name | VILLAGE OF DOLTON
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Dates
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Enumeration Date | 12/02/2013
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Last Update Date | 12/02/2013
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Provider Practice Location Address
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Address Line | 14022 PARK AVE
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City | DOLTON
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State | IL
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Zip | 60419-1029
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Country | US
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Telephone | 708-849-2145
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Fax | 708-841-2863
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Provider Business Mailing Address
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Address Line | 14022 PARK AVE
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City | DOLTON
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State | IL
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Zip | 60419-1029
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Country | US
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Telephone | 708-849-2145
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Fax | 708-841-2863
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Authorized Official
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Title or Position | FIRE CHIEF
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Name | MR. TERRENCE HUGHES
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Credential |
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Telephone | 708-201-3250
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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License Number | 03-04-1625
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License Number State | IL
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