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General NPI Number Information
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NPI Number | 1881929537
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Entity Type | Organization
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Legal Business Name | VILLAGE OF WESTERN SPRG
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Dates
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Enumeration Date | 10/14/2009
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Last Update Date | 10/14/2009
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Provider Practice Location Address
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Address Line | 4353 WOLF RD
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City | WESTERN SPRGS
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State | IL
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Zip | 60558-1416
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Country | US
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Telephone | 708-246-1182
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Fax | 708-246-4871
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Provider Business Mailing Address
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Address Line | 740 HILLGROVE AVE
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City | WESTERN SPRGS
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State | IL
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Zip | 60558-1409
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Country | US
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Telephone | 708-246-1182
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Fax | 708-246-4871
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Authorized Official
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Title or Position | PARAMEDIC FIREFIGHTER
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Name | MS. DONNA M RUCH
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Credential |
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Telephone | 708-246-1182
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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 | 08 8084
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License Number State | IL
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