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NPI Code Detail

MEDICARE: METRO PARAMEDIC SERVICE INC

MEDICARE: METRO PARAMEDIC SERVICE INC
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
13416L0300XLand Ambulance87918IL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2590011946OTHERILRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1022-20451OTHERILBLUE CROSS BLUE SHIELD

General Provider Information

NPI Number : 1215993860
Entity Type Code : Organization
Provider Name (Legal Business Name) : METRO PARAMEDIC SERVICE INC
Provider Business Mailing Address
First Line : 395 W LAKE ST
Second Line : ATTN: KIMBERLY FULLER
City : ELMHURST
State : IL
Zip : 60126-1508
Country : US
Telephone Number : 630-903-2372
Fax Number : 630-903-2830
Provider Business Practice Location Address
First Line : 395 W LAKE ST
Second Line :
City : ELMHURST
State : IL
Zip : 60126-1508
Country : US
Telephone Number : 630-530-2988
Fax Number : 630-903-2830
Authorized Official
Title or Position : VICE PRESIDENT
Name : MICHAEL TILLMAN III
Credential :
Telephone Number : 630-903-2480
Provider Enumeration Date : 04/24/2006
Last Update Date : 01/26/2012

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Directions to “METRO PARAMEDIC SERVICE INC ” Practice Location

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