Village of Berkeley
Organization Active NPI Land Ambulance · Berkeley, IL
NPI 1073551990 · NPPES record last updated Sep 5, 2025
Key facts
- NPI
- 1073551990
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Land Ambulance 3416L0300X
- License
- 88918 (IL)
- Legal business name
- VILLAGE OF BERKELEY
- Practice address
- 5819 Electric Ave
Berkeley, IL 60163-1522 - Phone
- (708) 449-9444
- Fax
- (708) 449-6189
- NPI assigned
- Jun 3, 2006
- Organization subpart
- No
Authorized official
- Name
- Timothy Larem
- Title
- Public Safety Director
- Phone
- (708) 234-2627
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20111212000599 | IL | Part B Supplier - Ambulance Service Supplier | 7618142191 | Practice locations: Berkeley, IL |
National Provider Directory
Locations
5819 Electric Ave
Berkeley, IL 60163
Phone (708) 449-9444
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | 88918 | IL | Yes |
Addresses
Primary practice location
5819 Electric Ave
Berkeley, IL 60163-1522
Mailing address
PO Box 6253
Carol Stream, IL 60197-6253
Phone (630) 630-2988
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01632188 | Other | IL | BLUE CROSS BLUE SHIELD |
| 590014942 | Other | IL | MEDICARE RAILROAD |
Other providers in Berkeley, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 5, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.