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General NPI Number Information
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NPI Number | 1851332159
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Entity Type | Organization
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Legal Business Name | CITY OF PARK RIDGE
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Dates
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Enumeration Date | 06/09/2006
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Last Update Date | 03/16/2016
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Provider Practice Location Address
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Address Line | 505 BUTLER PLACE
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City | PARK RIDGE
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State | IL
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Zip | 60068-4648
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Country | US
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Telephone | 847-318-5264
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Fax | 847-318-5314
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Provider Business Mailing Address
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Address Line | 505 BUTLER PLACE
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City | PARK RIDGE
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State | IL
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Zip | 60068-4648
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Country | US
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Telephone | 847-318-5264
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Fax |
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Authorized Official
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Title or Position | LIEUTENANT
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Name | MATTHEW SCOTT JARKA
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Credential |
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Telephone | 630-337-8174
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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 | 8194
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License Number State | IL
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