# TOWN OF CICERO

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

## Provider details

- **NPI number:** 1154337889
- **Authorized official:** DAVID A GONZALEZ (FINANCE DIRECTOR)
- **Authorized official phone:** (708) 656-3600

## Contact information

- **Practice address:** 5303 W 25TH ST, CICERO, IL 60804-3311
- **Practice address phone:** (708) 652-0174
- **Practice address fax:** (708) 652-2150
- **Mailing address:** 5303 W 25TH ST, CICERO, IL 60804-3311
- **Mailing address phone:** (708) 652-0174
- **Mailing address fax:** (708) 652-2150

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | 87918 | IL | Yes |

## Other

- **Enumeration date:** 08/01/2006
- **Last updated:** 05/11/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 016-71119 | BCBS | IL |