Provider Demographics
NPI:1376554592
Name:CITY OF CHICAGO
Entity Type:Organization
Organization Name:CITY OF CHICAGO
Other - Org Name:CITY OF CHICAGO EMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DEPUTY DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:
Authorized Official - Last Name:FLORES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-744-4002
Mailing Address - Street 1:33589 TREASURY CTR
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60694-3500
Mailing Address - Country:US
Mailing Address - Phone:312-742-7065
Mailing Address - Fax:312-744-4792
Practice Address - Street 1:121 N. LASALLE
Practice Address - Street 2:ROOM 107A
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60602-1288
Practice Address - Country:US
Practice Address - Phone:312-742-7065
Practice Address - Fax:312-744-4792
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CITY OF CHICAGO
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-08-11
Last Update Date:2013-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL118700146L00000X
IL118701146N00000X
IL000008700341600000X
341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes341600000XTransportation ServicesAmbulanceGroup - Multi-Specialty
No146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, ParamedicGroup - Multi-Specialty
No146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, BasicGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILE99981874OtherTAX ID NUMBER
IL590003768Medicare PIN
ILE99981874OtherTAX ID NUMBER