Village of Bridgeview

Primary specialty

AmbulanceTaxonomy code 341600000X

License

828201 Issued in IL

Legal business name

VILLAGE OF BRIDGEVIEW

Practice address

7500 S Oketo Ave
Bridgeview, IL 60455-2508

Phone

(708) 924-8250

Fax

(708) 924-8202

NPI assigned

Dec 20, 2006

Last updated

Mar 11, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Matthew Duzzak

Title

EMS Coordinator

Phone

(708) 259-6345

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

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

{
    "created_epoch": "1166572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646956800000",
    "number": "1275697609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7500 S OKETO AVE",
            "city": "BRIDGEVIEW",
            "state": "IL",
            "postal_code": "604551297",
            "telephone_number": "708-924-8250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7500 S OKETO AVE",
            "city": "BRIDGEVIEW",
            "state": "IL",
            "postal_code": "604552508",
            "telephone_number": "708-924-8250",
            "fax_number": "708-924-8202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VILLAGE OF BRIDGEVIEW",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-20",
        "last_updated": "2022-03-11",
        "certification_date": "2022-03-11",
        "status": "A",
        "authorized_official_last_name": "DUZZAK",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "EMS COORDINATOR",
        "authorized_official_telephone_number": "708-259-6345"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "IL",
            "license": "828201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Janette Donna Waksmanski, PTA
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• Walgreen Co (Walgreens #00089)

• Ambulance in Bridgeview, IL
• Providers in Bridgeview, IL by specialty
• Ambulance in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2022; 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.

Verify at the official NPI Registry.