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General NPI Number Information
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NPI Number | 1275552473
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Entity Type | Organization
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Legal Business Name | VILLAGE OF ELK GROVE VILLAGE
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Dates
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Enumeration Date | 07/19/2006
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Last Update Date | 03/11/2009
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Provider Practice Location Address
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Address Line | 901 WELLINGTON AVE
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City | ELK GROVE VILLAGE
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State | IL
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Zip | 60007-3456
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Country | US
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Telephone | 847-734-8002
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Fax | 847-734-8024
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Provider Business Mailing Address
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Address Line | PO BOX 457
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City | WHEELING
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State | IL
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Zip | 60090-0457
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Country | US
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Telephone | 847-577-8811
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Fax | 847-577-7967
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Authorized Official
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Title or Position | FIRE CHIEF
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Name | SCOTT MILLER
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Credential |
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Telephone | 847-734-8002
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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 | 8183
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License Number State | IL
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