Organization
VILLAGE OF LYONS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GORDON J NORD (FIRE CHIEF)
(773) 233-1170
Entity
Organization
Contact information
Practice address
7801 OGDEN AVE, LYONS, IL 60534-1216
(708) 447-8886
Mailing address
PO BOX 438495, CHICAGO, IL 60643-8495
(773) 233-1170
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
813101
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1670397
BC BS PROVIDER NUMBER
IL
01
—
611564200
DEPT. OF LABOR
IL
01
—
P00161187
RAILROAD RETIREMENT PROV.
IL
Enumeration date
12/19/2006
Last updated
10/21/2011
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