Provider Demographics
NPI:1831302959
Name:VILLAGE OF NILES
Entity Type:Organization
Organization Name:VILLAGE OF NILES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MAYOR
Authorized Official - Prefix:MR
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:BLAZE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-588-8000
Mailing Address - Street 1:1000 CIVIC CENTER DRIVE
Mailing Address - Street 2:
Mailing Address - City:NILES
Mailing Address - State:IL
Mailing Address - Zip Code:60714-3229
Mailing Address - Country:US
Mailing Address - Phone:847-588-8000
Mailing Address - Fax:
Practice Address - Street 1:999 CIVIC CENTER DR
Practice Address - Street 2:
Practice Address - City:NILES
Practice Address - State:IL
Practice Address - Zip Code:60714-3224
Practice Address - Country:US
Practice Address - Phone:847-588-8460
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-07
Last Update Date:2023-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health