Organization
VILLAGE OF MORTON GROVE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS J. FRIEL (FIRE CHIEF)
(847) 470-5226
Entity
Organization
Contact information
Practice address
6250 LINCOLN AVE, MORTON GROVE, IL 60053-2852
(847) 470-5226
(847) 965-7711
Mailing address
395 W LAKE ST, ELMHURST, IL 60126-1508
(630) 903-2372
(630) 903-2830
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
108188
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
016-70646
BCBS
IL
01
—
590013814
RAILROAD MEDICARE
IL
Enumeration date
08/01/2006
Last updated
01/30/2012
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