Provider Demographics
NPI:1699447607
Name:VILLAGE OF GLENWOOD
Entity type:Organization
Organization Name:VILLAGE OF GLENWOOD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:WELSH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-753-2440
Mailing Address - Street 1:1 ASSELBORN WAY
Mailing Address - Street 2:
Mailing Address - City:GLENWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60425-1401
Mailing Address - Country:US
Mailing Address - Phone:708-753-2440
Mailing Address - Fax:708-753-2442
Practice Address - Street 1:605 E. GLENWOOD-LANSING ROAD
Practice Address - Street 2:
Practice Address - City:GLENWOOD
Practice Address - State:IL
Practice Address - Zip Code:60425
Practice Address - Country:US
Practice Address - Phone:708-753-2440
Practice Address - Fax:708-753-2442
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-29
Last Update Date:2021-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport