Active NPI
Town of Cicero
- Land Ambulance
- Cicero, IL
National Provider Identifier
1154337889
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Land Ambulance
- License
- 87918
- Legal business name
- TOWN OF CICERO
- Practice address
- 5303 W 25TH St
Cicero, IL 60804-3311 - Phone
- (708) 652-0174
- Fax
- (708) 652-2150
- NPI assigned
- Aug 1, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- David A Gonzalez
- Title
- Finance Director
- Phone
- (708) 656-3600
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | 87918 | IL | Primary |
Addresses
Primary practice location
5303 W 25TH St
Cicero, IL 60804-3311
Mailing address
5303 W 25TH St
Cicero, IL 60804-3311
Phone (708) 652-0174
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 016-71119 | Other | IL | BCBS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080707000210 | IL | Part B Supplier - Ambulance Service Supplier | 8820160989 | Practice locations: Cicero, IL |
Other NPIs with the same Medicare PAC ID 1
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
National Provider Directory
National Provider Directory- Tax ID family
- Town of Cicero
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Public Health or Welfare Agency
- Cicero, IL
- NPI 1407005671
Locations
5303 W 25th St
Cicero, IL 60804
Phone (708) 652-0174
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Nurse Practitioner
- Oak Park, IL
- NPI 1942658927
-
- Family Nurse Practitioner
- Crest Hill, IL
- NPI 1366903866
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154390400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1683763200000",
"number": "1154337889",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5303 W 25TH ST",
"city": "CICERO",
"state": "IL",
"postal_code": "608043311",
"telephone_number": "708-652-0174",
"fax_number": "708-652-2150"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5303 W 25TH ST",
"city": "CICERO",
"state": "IL",
"postal_code": "608043311",
"telephone_number": "708-652-0174",
"fax_number": "708-652-2150"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "TOWN OF CICERO",
"organizational_subpart": "NO",
"enumeration_date": "2006-08-01",
"last_updated": "2023-05-11",
"certification_date": "2023-05-11",
"status": "A",
"authorized_official_last_name": "GONZALEZ",
"authorized_official_first_name": "DAVID",
"authorized_official_middle_name": "A",
"authorized_official_title_or_position": "FINANCE DIRECTOR",
"authorized_official_telephone_number": "708-656-3600"
},
"taxonomies": [
{
"code": "3416L0300X",
"taxonomy_group": "",
"desc": "Ambulance, Land Transport",
"state": "IL",
"license": "87918",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "016-71119",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cicero, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.