Organization
VILLAGE OF STONE PARK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL PAIGE (FIRE CHIEF)
(708) 450-3217
Entity
Organization
Contact information
Practice address
1745 N 35TH AVE, STONE PARK, IL 60165-1025
(708) 450-3217
(708) 450-3219
Mailing address
395 W LAKE ST, ELMHURST, IL 60126-1508
(630) 903-2381
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
88082
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01617299
BCBS
IL
Enumeration date
10/09/2006
Last updated
04/13/2020
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