Provider Demographics
NPI:1760579817
Name:VILLAGE OF WESTCHESTER
Entity Type:Organization
Organization Name:VILLAGE OF WESTCHESTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VILLAGE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:NOSEK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-345-0020
Mailing Address - Street 1:395 W LAKE ST
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:IL
Mailing Address - Zip Code:60126-1508
Mailing Address - Country:US
Mailing Address - Phone:630-903-2372
Mailing Address - Fax:630-903-2830
Practice Address - Street 1:10240 W ROOSEVELT RD
Practice Address - Street 2:
Practice Address - City:WESTCHESTER
Practice Address - State:IL
Practice Address - Zip Code:60154-2573
Practice Address - Country:US
Practice Address - Phone:708-345-0433
Practice Address - Fax:708-345-0089
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-09
Last Update Date:2020-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL880833416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL590007933OtherRAILROAD MEDICARE
IL01671551OtherBCBS
ID366006143001Medicaid
IL01671551OtherBCBS