Organization
VILLAGE OF MT PROSPECT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID O. ERB (FINANCE DIRECTOR)
(847) 392-6000
Entity
Organization
Contact information
Practice address
50 S EMERSON ST, MOUNT PROSPECT, IL 60056-3218
(847) 392-6000
(847) 818-5336
Mailing address
PO BOX 457, WHEELING, IL 60090
(847) 392-6000
(847) 818-5336
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
8189
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1671000
BCBS
IL
01
—
P00321665
RR MEDICARE
IL
Enumeration date
05/18/2006
Last updated
08/18/2009
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