NPIMap

Organization Active NPI

Alverno Lakeside Corporation

Doing business as Alverno Advanced Life Support Service

  • Ambulance
  • Olympia Fields, IL
National Provider Identifier
1124021266
Registry record updated Jan 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
AmbulanceTaxonomy code 341600000X
License
77967 Issued in IL
Legal business name
ALVERNO LAKESIDE CORPORATION
Doing business as
Alverno Advanced Life Support Service
Practice address
20201 Crawford Ave
Olympia Fields, IL 60461-1010
Phone
(708) 756-1200
Fax
(708) 481-5583
NPI assigned
May 23, 2005
Last updated
Jan 10, 2011By the provider in NPPES
Organization subpart
Yes
Parent organization
ST. JAMES HOSPITAL, UNITED STATES CATHOLIC CONFERENCEAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 10, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. John Slykas
Title
Manager
Phone
(708) 747-4000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulance 341600000X 77967 IL Primary

Addresses

Primary practice location

20201 Crawford Ave
Olympia Fields, IL 60461-1010

Mailing address

20201 Crawford Ave
Olympia Fields, IL 60461-1010
Phone (708) 747-4000

Other identifiers 2

IdentifierTypeStateIssuer
590014070OtherILMEDICARE RAILROAD
1626513OtherILBCBS PROVIDER NUMBER

Other names 1

  • Alverno Advanced Life Support Service Doing business as

National Provider Directory

National Provider Directory
Part of
St James Diabetes

Locations

20201 Crawford Ave
Olympia Flds, IL 60461
Phone (708) 503-3857

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1116806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294617600000",
    "number": "1124021266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20201 CRAWFORD AVE",
            "city": "OLYMPIA FIELDS",
            "state": "IL",
            "postal_code": "604611010",
            "telephone_number": "708-747-4000",
            "fax_number": "708-755-3392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20201 CRAWFORD AVE",
            "city": "OLYMPIA FIELDS",
            "state": "IL",
            "postal_code": "604611010",
            "telephone_number": "708-756-1200",
            "fax_number": "708-481-5583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALVERNO LAKESIDE CORPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ST. JAMES HOSPITAL, UNITED STATES CATHOLIC CONFERENCE",
        "enumeration_date": "2005-05-23",
        "last_updated": "2011-01-10",
        "status": "A",
        "authorized_official_last_name": "SLYKAS",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "708-747-4000",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "IL",
            "license": "77967",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "590014070",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "1626513",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Alverno Advanced Life Support Service",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Olympia Fields, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.