MEDICARE: VILLAGE OF WINTHROP HBR

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	7277	IL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	590012633	OTHER	IL	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	4920454	OTHER	IL	BCBS

General Provider Information

NPI Number	:	1871528133
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VILLAGE OF WINTHROP HBR

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	:	830 SHERIDAN RD
Second Line	:
City	:	WINTHROP HARBOR
State	:	IL
Zip	:	60096-1632
Country	:	US
Telephone Number	:	847-872-5957
Fax Number	:	847-872-1553

Authorized Official
Title or Position	:	FIRE CHIEF
Name	:	ROCCO CAMPANELLA
Credential	:
Telephone Number	:	847-872-5957

Provider Enumeration Date	:	07/12/2006
Last Update Date	:	09/08/2025

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Directions to “VILLAGE OF WINTHROP HBR ” Practice Location

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