Village of Calumet Park

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

78600 Issued in IL

Legal business name

VILLAGE OF CALUMET PARK

Practice address

12409 S Throop St
Calumet Park, IL 60827-5819

Phone

(773) 233-1170

Fax

(773) 233-8146

NPI assigned

Jul 30, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Thomas Battistella

Title

Fire Chief

Phone

(773) 233-1170

Specialties & licenses 1

Addresses

Other identifiers 1

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": "1154217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225152000000",
    "number": "1437164282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 438495",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606438495",
            "telephone_number": "773-233-1170",
            "fax_number": "773-233-8146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12409 S THROOP ST",
            "city": "CALUMET PARK",
            "state": "IL",
            "postal_code": "608275819",
            "telephone_number": "773-233-1170",
            "fax_number": "773-233-8146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VILLAGE OF CALUMET PARK",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-30",
        "last_updated": "2008-10-28",
        "status": "A",
        "authorized_official_last_name": "BATTISTELLA",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "FIRE CHIEF",
        "authorized_official_telephone_number": "773-233-1170",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "IL",
            "license": "78600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "016-70820",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Land Ambulance in Calumet Park, IL
• Providers in Calumet Park, IL by specialty
• Land Ambulance in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2008; 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.