1992053029 NPI number — FOUNDATION FOR EMERGENCY SERVICES

Table of content: (NPI 1992053029)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1992053029 NPI number — FOUNDATION FOR EMERGENCY SERVICES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FOUNDATION FOR EMERGENCY SERVICES
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1992053029
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/25/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 809616
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHICAGO
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60680-8802
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
773-962-4073
Provider Business Mailing Address Fax Number:
773-962-9276

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8331 S STEWART AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHICAGO
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60620-1728
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
773-420-1234
Provider Business Practice Location Address Fax Number:
773-420-1233
Provider Enumeration Date:
08/21/2012

Additional Information

Authorized Official

Authorized Official Last Name:
ALTON
Authorized Official First Name:
GUY
Authorized Official Middle Name:
RICHARD
Authorized Official Title or Position:
CHIEF FINANCIAL OFFICER
Authorized Official Telephone Number:
773-962-4073

Provider Taxonomy Codes

  • Taxonomy code: 261QP2300X , with the licence number:  0002303 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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