# CITY OF PARK RIDGE

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

## Provider details

- **NPI number:** 1851332159
- **Authorized official:** MATTHEW SCOTT JARKA (LIEUTENANT)
- **Authorized official phone:** (630) 337-8174

## Contact information

- **Practice address:** 505 BUTLER PLACE, PARK RIDGE, IL 60068-4648
- **Practice address phone:** (847) 318-5264
- **Practice address fax:** (847) 318-5314
- **Mailing address:** 505 BUTLER PLACE, PARK RIDGE, IL 60068-4648
- **Mailing address phone:** (847) 318-5264

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | 8194 | IL | Yes |

## Other

- **Enumeration date:** 06/09/2006
- **Last updated:** 03/16/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1670787 | BCBS | IL |
| 01 | — | 590007926 | RR MEDICARE | IL |