Provider Demographics
NPI:1649211954
Name:VILLAGE OF POSEN
Entity Type:Organization
Organization Name:VILLAGE OF POSEN
Other - Org Name:POSEN FIRE DEPARTMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:SZEWCZYK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-385-3110
Mailing Address - Street 1:PO BOX 438495
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60643-8495
Mailing Address - Country:US
Mailing Address - Phone:773-233-1170
Mailing Address - Fax:773-233-1170
Practice Address - Street 1:2440 W WALTER ZIMNY DR
Practice Address - Street 2:
Practice Address - City:POSEN
Practice Address - State:IL
Practice Address - Zip Code:60469-1344
Practice Address - Country:US
Practice Address - Phone:708-385-3110
Practice Address - Fax:708-389-5293
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-09
Last Update Date:2012-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL85823416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1649211954OtherBLUE CROSS/BLUE SHIEFL
IL590004073OtherRR MEDICARE
IL=========OtherTRICARE NORTH
IL590004073OtherRR MEDICARE
IL590004073OtherRR MEDICARE