Organization
VILLAGE OF LOMBARD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PAUL DIRIENZO (EMERGENCY MEDICAL SERVICES CHIEF)
(630) 620-5736
Entity
Organization
Contact information
Practice address
255 E WILSON AVE, LOMBARD, IL 60148-3926
(630) 620-5736
Mailing address
255 E WILSON AVE, LOMBARD, IL 60148-3926
(630) 873-4501
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2270151
BCBS OF IL
IL
Enumeration date
07/19/2005
Last updated
09/20/2011
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