MEDICARE: VILLAGE OF ARLINGTON HEIGHTS A

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	98178	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1670140	OTHER	IL	BCBS PROVIDER NUMBER
2	132855900	OTHER	IL	DEPT OF LABOR OWCP

General Provider Information

NPI Number	:	1306849567
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VILLAGE OF ARLINGTON HEIGHTS A

Provider Business Mailing Address
First Line	:	PO BOX 7134
Second Line	:
City	:	CAROL STREAM
State	:	IL
Zip	:	60197-7134
Country	:	US
Telephone Number	:	847-368-5450
Fax Number	:

Provider Business Practice Location Address
First Line	:	33 S ARLINGTON HEIGHTS RD
Second Line	:
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60005-1403
Country	:	US
Telephone Number	:	847-368-5000
Fax Number	:	847-368-5995

Authorized Official
Title or Position	:	CHIEF
Name	:	LANCE HARRIS
Credential	:
Telephone Number	:	847-368-5450

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	12/11/2023

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