Provider Demographics
NPI:1679506224
Name:VILLAGE OF WESTMONT
Entity Type:Organization
Organization Name:VILLAGE OF WESTMONT
Other - Org Name:WESTMONT FIRE DEPARTMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:
Authorized Official - Last Name:TROUT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-829-4480
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:847-577-7967
Practice Address - Street 1:6015 S CASS AVE
Practice Address - Street 2:
Practice Address - City:WESTMONT
Practice Address - State:IL
Practice Address - Zip Code:60559-2611
Practice Address - Country:US
Practice Address - Phone:630-829-4480
Practice Address - Fax:630-829-4486
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-08
Last Update Date:2008-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL72283416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL2283025OtherBCBS
IL590014797OtherRR MEDICARE
IL590014797OtherRR MEDICARE
IL2283025OtherBCBS
IL2283025OtherBCBS
IL=========OtherTRICARE NORTH
IL590014797Medicare PIN