Provider Demographics
NPI:1083615728
Name:VILLAGE OF CLARENDON HILLS
Entity Type:Organization
Organization Name:VILLAGE OF CLARENDON HILLS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:M
Authorized Official - Last Name:HARTNETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-286-5415
Mailing Address - Street 1:1 N POSPECT AVE
Mailing Address - Street 2:
Mailing Address - City:CLARENDON HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60514
Mailing Address - Country:US
Mailing Address - Phone:630-323-3500
Mailing Address - Fax:630-323-3512
Practice Address - Street 1:1 N POSPECT AVE
Practice Address - Street 2:
Practice Address - City:CLARENDON HILLS
Practice Address - State:IL
Practice Address - Zip Code:60514
Practice Address - Country:US
Practice Address - Phone:630-323-3530
Practice Address - Fax:630-323-3512
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-03
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3416A0800X
IL341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
No3416A0800XTransportation ServicesAmbulanceAir Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL2271372OtherBCBS OF IL
IL=========001Medicaid
IL=========001Medicaid