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Organization

VILLAGE OF MATTESON

Active
Other names
Matteson Fire Department
Organization subpart
No

Provider details

NPI number
Authorized official
NICK WILKINS (FIRE CHIEF)
(708) 748-5129
Entity
Organization

Contact information

Practice address
3445 211TH ST, MATTESON, IL 60443-2521
(708) 748-5129
(708) 283-6606
Mailing address
PO BOX 457, WHEELING, IL 60090-0457
(847) 577-8811
(847) 577-7967

Taxonomy

Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
8171
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1690076
BCBS
IL
01
590009914
RR MEDICARE
IL
Enumeration date
05/26/2006
Last updated
06/30/2008
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