Provider Demographics
NPI:1851326201
Name:VILLAGE OF WESTERN SPRINGS
Entity Type:Organization
Organization Name:VILLAGE OF WESTERN SPRINGS
Other - Org Name:VILLAGE OF WESTERN SPRG
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:KENNY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-246-1800
Mailing Address - Street 1:4353 WOLF RD.
Mailing Address - Street 2:
Mailing Address - City:WESTERN SPRINGS
Mailing Address - State:IL
Mailing Address - Zip Code:60558-1416
Mailing Address - Country:US
Mailing Address - Phone:708-246-1800
Mailing Address - Fax:708-246-4871
Practice Address - Street 1:4353 WOLF RD.
Practice Address - Street 2:
Practice Address - City:WESTERN SPRINGS
Practice Address - State:IL
Practice Address - Zip Code:60558-1416
Practice Address - Country:US
Practice Address - Phone:708-246-1800
Practice Address - Fax:708-246-4871
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-12
Last Update Date:2016-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL80843416L0300X
IL3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1620231OtherBCBS
IL1620231OtherBCBS
IL370390Medicare PIN
IL1620231OtherBCBS