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Organization

CITY OF BERWYN

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ROBERT PILCH (DIVISION CHIEF)
(708) 749-6347
Entity
Organization

Contact information

Practice address
6700 26TH ST, BERWYN, IL 60402-2500
(708) 788-2660
(708) 788-3990
Mailing address
PO BOX 6253, CAROL STREAM, IL 60197-6253
(630) 530-2988
(630) 832-9750

Taxonomy

Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
805401
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000026648
MEDICAID PROVIDER, WISC.
WI
01
1670585
BC BS PROVIDER NUMBER
IL
01
590004104
RAILROAD RETIREMENT #
IL
Enumeration date
12/19/2006
Last updated
09/05/2025
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