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Organization
CITY OF NAPERVILLE ILL
Active
Organization
CITY OF NAPERVILLE ILL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK PUKNAITIS (CHIEF)
(630) 305-5900
Entity
Organization
Contact information
Practice address
400 S EAGLE ST, NAPERVILLE, IL 60540-5279
(630) 305-5900
(630) 420-4094
Mailing address
395 W LAKE ST, ELMHURST, IL 60126-1508
(630) 530-2372
(630) 903-2830
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
87222
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
022-70002
BLUE CROSS BLUE SHIELD
IL
01
—
590008635
RAILROAD MEDICARE
IL
Enumeration date
05/12/2006
Last updated
04/26/2012
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