Provider Demographics
NPI:1023018652
Name:VILLAGE OF VILLA PARK OFFICE OF THE TREASURER
Entity Type:Organization
Organization Name:VILLAGE OF VILLA PARK OFFICE OF THE TREASURER
Other - Org Name:VILLA PARK FIRE DEPT.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FINANCE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:WACHTEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-834-8500
Mailing Address - Street 1:20 S. ARDMORE AVE.
Mailing Address - Street 2:
Mailing Address - City:VILLA PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60181
Mailing Address - Country:US
Mailing Address - Phone:630-833-5350
Mailing Address - Fax:630-941-5978
Practice Address - Street 1:1440 S.ARDMORE AVE.
Practice Address - Street 2:
Practice Address - City:VILLA PARK
Practice Address - State:IL
Practice Address - Zip Code:60181
Practice Address - Country:US
Practice Address - Phone:630-833-5350
Practice Address - Fax:630-941-5978
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VILLAGE OF VILLA PARK OFFICE OF THE TREASURER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-07-26
Last Update Date:2020-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL2270933OtherBCBS OF IL
IL2270933OtherBCBS OF IL
696600Medicare PIN