MEDICARE: CITY OF CHICAGO HEIGHTS

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	78153	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0967077	OTHER	IL	AETNA
2	1617344	OTHER	IL	BCBS
3	N288251	OTHER	IL	HARMONY
4	202473	OTHER	IL	UNITED HEALTHCARE
5	20886	OTHER	IL	AMERIGROUP

General Provider Information

NPI Number	:	1144395864
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CITY OF CHICAGO HEIGHTS

Provider Business Mailing Address
First Line	:	PO BOX 6253
Second Line	:
City	:	CAROL STREAM
State	:	IL
Zip	:	60197-6253
Country	:	US
Telephone Number	:	630-530-2988
Fax Number	:	630-832-9750

Provider Business Practice Location Address
First Line	:	83 E JOE ORR RD
Second Line	:
City	:	CHICAGO HEIGHTS
State	:	IL
Zip	:	60411-1223
Country	:	US
Telephone Number	:	708-756-5370
Fax Number	:	708-756-5358

Authorized Official
Title or Position	:	MAYOR
Name	:	DAVID A GONZALEZ
Credential	:
Telephone Number	:	708-656-3600

Provider Enumeration Date	:	11/21/2006
Last Update Date	:	09/05/2025

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Directions to “CITY OF CHICAGO HEIGHTS ” Practice Location

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