MEDICARE: VILLAGE OF BERKELEY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3416L0300X	Land Ambulance	88918	IL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	590014942	OTHER	IL	MEDICARE RAILROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	01632188	OTHER	IL	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1073551990
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VILLAGE OF BERKELEY

Provider Business Mailing Address
First Line	:	PO BOX 6253
Second Line	:
City	:	CAROL STREAM
State	:	IL
Zip	:	60197-6253
Country	:	US
Telephone Number	:	630-630-2988
Fax Number	:	630-832-9750

Provider Business Practice Location Address
First Line	:	5819 ELECTRIC AVE
Second Line	:
City	:	BERKELEY
State	:	IL
Zip	:	60163-1522
Country	:	US
Telephone Number	:	708-449-9444
Fax Number	:	708-449-6189

Authorized Official
Title or Position	:	PUBLIC SAFETY DIRECTOR
Name	:	TIMOTHY LAREM
Credential	:
Telephone Number	:	708-234-2627

Provider Enumeration Date	:	06/03/2006
Last Update Date	:	09/05/2025

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Directions to “VILLAGE OF BERKELEY ” Practice Location

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