Provider Demographics
NPI:1891030524
Name:PARAMEDIC SERVICES OF ILLINOIS INC,
Entity Type:Organization
Organization Name:PARAMEDIC SERVICES OF ILLINOIS INC,
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:FIELD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-678-4900
Mailing Address - Street 1:9815 LAWRENCE AVE
Mailing Address - Street 2:
Mailing Address - City:SCHILLER PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60176-1125
Mailing Address - Country:US
Mailing Address - Phone:847-678-4900
Mailing Address - Fax:847-678-2854
Practice Address - Street 1:1410 E JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:IL
Practice Address - Zip Code:61727-1846
Practice Address - Country:US
Practice Address - Phone:217-570-0176
Practice Address - Fax:217-570-0177
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-06
Last Update Date:2012-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL088944341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL6017601Medicaid
590003882OtherR.R. MEDICARE
IL1620086OtherBLUECROSS
IL358890Medicare PIN