# VILLAGE OF WILMETTE

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Wilmette Fire Department
- **Organization subpart:** No

## Provider details

- **NPI number:** 1205855707
- **Authorized official:** JOHN ROBBERSON (FIRE CHIEF)
- **Authorized official phone:** (847) 251-2700

## Contact information

- **Practice address:** 1304 LAKE AVE, WILMETTE, IL 60091-1664
- **Practice address phone:** (847) 251-2700
- **Practice address fax:** (847) 853-7642
- **Mailing address:** PO BOX 457, WHEELING, IL 60090-0457
- **Mailing address phone:** (847) 577-8811
- **Mailing address fax:** (847) 577-7967

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | 8202 | IL | Yes |

## Other

- **Enumeration date:** 07/18/2006
- **Last updated:** 08/27/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1632895 | BCBS | IL |
| 01 | — | 590015238 | RR MEDICARE | IL |
| 01 | — | 611708300 | DOL OWCP | IL |