Provider Demographics
NPI:1740208578
Name:VILLAGE OF FRANKLIN PARK
Entity Type:Organization
Organization Name:VILLAGE OF FRANKLIN PARK
Other - Org Name:FRANKLINPARK FIRE DEPARTMENT
Other - Org Type:Other Name
Authorized Official - Title/Position:VILLAGE COMPTROLLER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:C
Authorized Official - Last Name:HOUGH
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:847-671-8223
Mailing Address - Street 1:9500 W BELMONT AVE
Mailing Address - Street 2:VILLAGE OF FRANKLIN PARK
Mailing Address - City:FRANKLIN PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60131
Mailing Address - Country:US
Mailing Address - Phone:847-671-8223
Mailing Address - Fax:847-671-0221
Practice Address - Street 1:9500 W BELMONT AVE
Practice Address - Street 2:VILLAGE OF FRANKLIN PARK
Practice Address - City:FRANKLIN PARK
Practice Address - State:IL
Practice Address - Zip Code:60131
Practice Address - Country:US
Practice Address - Phone:847-671-8223
Practice Address - Fax:847-671-0221
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-18
Last Update Date:2007-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1690077341600000X
IL1690076341600000X
IL1690079341600000X
IL1690678341600000X
IL1690078341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL760110Medicare PIN