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General NPI Number Information
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NPI Number | 1104811967
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Entity Type | Organization
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Legal Business Name | VILLAGE OF BOLINGBROOK ILLINOIS
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Dates
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Enumeration Date | 09/16/2005
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Last Update Date | 09/05/2025
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Provider Practice Location Address
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Address Line | 375 W BRIARCLIFF RD
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City | BOLINGBROOK
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State | IL
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Zip | 60440-3825
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Country | US
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Telephone | 630-226-8540
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Fax | 630-759-4016
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Provider Business Mailing Address
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Address Line | PO BOX 6253
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City | CAROL STREAM
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State | IL
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Zip | 60197-6253
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Country | US
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Telephone | 630-530-2988
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Fax | 630-832-9750
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Authorized Official
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Title or Position | FIRE CHIEF
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Name | JEFFERY ROLAND LAJOIE
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Credential |
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Telephone | 630-226-8540
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number |
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License Number State |
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