MEDICARE: VILLAGE OF CLARENDON HILLS

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	3416A0800X	Air Ambulance
2	341600000X	Ambulance	000721001	IL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	590007567	OTHER		RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2271372	OTHER	IL	BCBS OF IL

General Provider Information

NPI Number	:	1083615728
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VILLAGE OF CLARENDON HILLS

Provider Business Mailing Address
First Line	:	1 N POSPECT AVE
Second Line	:
City	:	CLARENDON HILLS
State	:	IL
Zip	:	60514
Country	:	US
Telephone Number	:	630-323-3500
Fax Number	:	630-323-3512

Provider Business Practice Location Address
First Line	:	1 N POSPECT AVE
Second Line	:
City	:	CLARENDON HILLS
State	:	IL
Zip	:	60514
Country	:	US
Telephone Number	:	630-323-3530
Fax Number	:	630-323-3512

Authorized Official
Title or Position	:	FINANCE DIRECTOR
Name	:	MAUREEN B POTEMPA
Credential	:
Telephone Number	:	630-286-5415

Provider Enumeration Date	:	08/03/2005
Last Update Date	:	09/05/2025

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1275521320 — ANDREW JOSEPH SCHUBKEGEL MD
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1528030178 — MRS. JENNIFER CHIARAMONTE ATC
Practice Location Address:

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Directions to “VILLAGE OF CLARENDON HILLS ” Practice Location

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