# VILLAGE OF LIBERTYVILLE

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

## Provider details

- **NPI number:** 1316990286
- **Authorized official:** MR. RICHARD MICHAEL CARANI MPA (FIRE CHIEF)
- **Authorized official phone:** (847) 362-5664

## Contact information

- **Practice address:** 1551 N MILWAUKEE AVE, LIBERTYVILLE, IL 60048-1394
- **Practice address phone:** (847) 362-5664
- **Practice address fax:** (847) 362-8829
- **Mailing address:** 1551 N MILWAUKEE AVE, LIBERTYVILLE, IL 60048-1394
- **Mailing address phone:** (847) 362-5664
- **Mailing address fax:** (847) 362-8829

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | 10-7265 | IL | Yes |

## Other

- **Enumeration date:** 05/19/2006
- **Last updated:** 06/17/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 717060 | — | IL |