City of Edwardsville

Primary specialty

AmbulanceTaxonomy code 341600000X

License

4818 Issued in IL

Legal business name

CITY OF EDWARDSVILLE

Practice address

118 Hillsboro Ave
Edwardsville, IL 62025-1622

Phone

(618) 692-7500

Fax

(618) 692-7558

NPI assigned

Jul 20, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Patty J Thiede

Title

City Clerk/Comptroller

Phone

(618) 692-7500

Specialties & licenses 1

Addresses

Other identifiers 3

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": "1153353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618531200000",
    "number": "1841210366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 HILLSBORO AVE",
            "city": "EDWARDSVILLE",
            "state": "IL",
            "postal_code": "620251622",
            "telephone_number": "618-692-7500",
            "fax_number": "618-692-7558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 HILLSBORO AVE",
            "city": "EDWARDSVILLE",
            "state": "IL",
            "postal_code": "620251622",
            "telephone_number": "618-692-7500",
            "fax_number": "618-692-7558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF EDWARDSVILLE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-20",
        "last_updated": "2021-04-16",
        "certification_date": "2021-04-16",
        "status": "A",
        "authorized_official_last_name": "THIEDE",
        "authorized_official_first_name": "PATTY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CITY CLERK/COMPTROLLER",
        "authorized_official_telephone_number": "618-692-7500",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "IL",
            "license": "4818",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA",
            "identifier": "590155530",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP HEALTH",
            "identifier": "32180",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "6090016",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mickey Charles Christian
• Christina J. Levi O D P C
• Christina J. Levi O D P C
• Christina J. Levi O D P C
• Kenechi Millicent Chukwuwike
• Clarkson Optometry Illinois PC
• Dale Glen Claussen, DMD
• Ryan J Cleland, D.C.
• Kylie Clemens, RBT
• Jacquelyn M. Clement, PH.D., F.N.P.-B.C.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2021; 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.