# VILLAGE OF LOMBARD

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1073512240
- **Authorized official:** MR. PAUL DIRIENZO (EMERGENCY MEDICAL SERVICES CHIEF)
- **Authorized official phone:** (630) 620-5736

## Contact information

- **Practice address:** 255 E WILSON AVE, LOMBARD, IL 60148-3926
- **Practice address phone:** (630) 620-5736
- **Mailing address:** 255 E WILSON AVE, LOMBARD, IL 60148-3926
- **Mailing address phone:** (630) 873-4501

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | — | IL | Yes |

## Other

- **Enumeration date:** 07/19/2005
- **Last updated:** 09/20/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2270151 | BCBS OF IL | IL |