# VILLAGE OF MATTESON

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

## Provider details

- **NPI number:** 1407802721
- **Authorized official:** NICK WILKINS (FIRE CHIEF)
- **Authorized official phone:** (708) 748-5129

## Contact information

- **Practice address:** 3445 211TH ST, MATTESON, IL 60443-2521
- **Practice address phone:** (708) 748-5129
- **Practice address fax:** (708) 283-6606
- **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 | 8171 | IL | Yes |

## Other

- **Enumeration date:** 05/26/2006
- **Last updated:** 06/30/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1690076 | BCBS | IL |
| 01 | — | 590009914 | RR MEDICARE | IL |