MEDICARE: PARAMEDIC SERVICES OF ILLINOIS 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
1	341600000X	Ambulance	088944	IL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	590003882	OTHER		R.R. MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	1620086	OTHER	IL	BLUECROSS

General Provider Information

NPI Number	:	1891030524
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PARAMEDIC SERVICES OF ILLINOIS INC,

Provider Business Mailing Address
First Line	:	9815 LAWRENCE AVE
Second Line	:
City	:	SCHILLER PARK
State	:	IL
Zip	:	60176-1125
Country	:	US
Telephone Number	:	847-678-4900
Fax Number	:	847-678-2854

Provider Business Practice Location Address
First Line	:	1410 E JEFFERSON ST
Second Line	:
City	:	CLINTON
State	:	IL
Zip	:	61727-1846
Country	:	US
Telephone Number	:	217-570-0176
Fax Number	:	217-570-0177

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MS. MARY FIELD
Credential	:
Telephone Number	:	847-678-4900

Provider Enumeration Date	:	12/06/2012
Last Update Date	:	12/06/2012

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