Provider Demographics
NPI:1033206198
Name:CITY OF ROLLING MEADOWS
Entity Type:Organization
Organization Name:CITY OF ROLLING MEADOWS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FIRE
Authorized Official - Prefix:MR
Authorized Official - First Name:PHILLIP
Authorized Official - Middle Name:
Authorized Official - Last Name:BURNS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-397-3352
Mailing Address - Street 1:PO BOX 457
Mailing Address - Street 2:
Mailing Address - City:WHEELING
Mailing Address - State:IL
Mailing Address - Zip Code:60090-0457
Mailing Address - Country:US
Mailing Address - Phone:847-577-8811
Mailing Address - Fax:847-577-3518
Practice Address - Street 1:2455 PLUM GROVE RD
Practice Address - Street 2:
Practice Address - City:ROLLING MEADOWS
Practice Address - State:IL
Practice Address - Zip Code:60008-2052
Practice Address - Country:US
Practice Address - Phone:847-397-3352
Practice Address - Fax:847-397-7489
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-09
Last Update Date:2008-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL981963416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01671104OtherBCBS
IL613407300OtherDOL OWCP
IL590013132OtherRR MEDICARE
IL613407300OtherDOL OWCP
IL613407300OtherDOL OWCP
IL590013132Medicare PIN