Provider Demographics
NPI:1699078337
Name:VILLAGE OF CHAPIN
Entity type:Organization
Organization Name:VILLAGE OF CHAPIN
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:BRYCE
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:MCCORMICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:217-370-9994
Mailing Address - Street 1:510 EVERETT STREET
Mailing Address - Street 2:PO BOX 213
Mailing Address - City:CHAPIN
Mailing Address - State:IL
Mailing Address - Zip Code:62628-0213
Mailing Address - Country:US
Mailing Address - Phone:217-472-3111
Mailing Address - Fax:217-472-5101
Practice Address - Street 1:510 EVERETT STREET
Practice Address - Street 2:
Practice Address - City:CHAPIN
Practice Address - State:IL
Practice Address - Zip Code:62628-0213
Practice Address - Country:US
Practice Address - Phone:217-472-3111
Practice Address - Fax:217-472-5101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-20
Last Update Date:2019-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL033023341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance