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Organization

VILLAGE OF RICHTON PARK

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. RODNEY WILSON PARAMEDIC (FIRE CHIEF)
(708) 478-5694
Entity
Organization

Contact information

Practice address
4455 SAUK TRL, RICHTON PARK, IL 60471-1126
(773) 233-1170
(773) 233-8146
Mailing address
PO BOX 1053, MOKENA, IL 60448-2052
(708) 478-5694

Taxonomy

Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
891001
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1634154
BC BS ILLINOIS
IL
01
590009158
RAILROAD RETIREMENT
IL
Enumeration date
12/20/2006
Last updated
12/10/2019
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