Provider Demographics
NPI:1942397013
Name:VILLAGE OF SKOKIE
Entity Type:Organization
Organization Name:VILLAGE OF SKOKIE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:RALPH
Authorized Official - Middle Name:
Authorized Official - Last Name:CZERWINSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-982-5320
Mailing Address - Street 1:PO BOX 6275
Mailing Address - Street 2:
Mailing Address - City:CAROL STREAM
Mailing Address - State:IL
Mailing Address - Zip Code:60197-6275
Mailing Address - Country:US
Mailing Address - Phone:708-478-5694
Mailing Address - Fax:708-478-5879
Practice Address - Street 1:5127 OAKTON ST
Practice Address - Street 2:
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60077
Practice Address - Country:US
Practice Address - Phone:847-982-5320
Practice Address - Fax:847-675-2318
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-09
Last Update Date:2018-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1081983416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL590014282OtherRAILROAD MEDICARE
IL01620631OtherBCBS
IL590014282OtherRAILROAD MEDICARE
IL590014282OtherRAILROAD MEDICARE