Organization
CITY OF OGLESBY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CATHIE EDENS (DIRECTOR)
(815) 883-3663
Entity
Organization
Contact information
Practice address
500 S COLUMBIA AVE, OGLESBY, IL 61348-1469
(815) 883-3663
(815) 883-5122
Mailing address
500 S COLUMBIA AVE, OGLESBY, IL 61348-1469
(815) 883-3663
(815) 883-5122
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
2 2615
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05070823
BLUE CROSS BLUE SHIELDS
IL
Enumeration date
08/28/2006
Last updated
04/20/2008
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