MEDICARE: CITY OF HIGHLAND PARK

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	107258	IL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	590001527	OTHER	IL	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	049-70559	OTHER	IL	BCBS

General Provider Information

NPI Number	:	1295740736
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CITY OF HIGHLAND PARK

Provider Business Mailing Address
First Line	:	PO BOX 1368
Second Line	:
City	:	ELMHURST
State	:	IL
Zip	:	60126-8368
Country	:	US
Telephone Number	:	630-530-2988
Fax Number	:	630-832-9750

Provider Business Practice Location Address
First Line	:	1130 CENTRAL AVE
Second Line	:
City	:	HIGHLAND PARK
State	:	IL
Zip	:	60035-3299
Country	:	US
Telephone Number	:	847-433-3110
Fax Number	:	847-432-0699

Authorized Official
Title or Position	:	FIRE CHIEF
Name	:	JOSEPH SCHRAGE
Credential	:
Telephone Number	:	847-926-1067

Provider Enumeration Date	:	07/31/2006
Last Update Date	:	09/08/2025

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Directions to “CITY OF HIGHLAND PARK ” Practice Location

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