1306849567 NPI number — VILLAGE OF ARLINGTON HEIGHTS A

Table of content: (NPI 1306849567)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1306849567 NPI number — VILLAGE OF ARLINGTON HEIGHTS A

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
VILLAGE OF ARLINGTON HEIGHTS A
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1306849567
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/11/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 7134
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CAROL STREAM
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60197-7134
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
847-368-5450
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
33 S ARLINGTON HEIGHTS RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ARLINGTON HEIGHTS
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60005-1403
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
847-368-5000
Provider Business Practice Location Address Fax Number:
847-368-5995
Provider Enumeration Date:
05/23/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
HARRIS
Authorized Official First Name:
LANCE
Authorized Official Middle Name:
Authorized Official Title or Position:
CHIEF
Authorized Official Telephone Number:
847-368-5450

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X , with the licence number:  98178 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1670140 . This is a "BCBS PROVIDER NUMBER" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: 132855900 . This is a "DEPT OF LABOR OWCP" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".