Basic Information
| Provider Information | |||||||||
| NPI: | 1366489791 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | VILLAGE OF BARRINGTON COOK & LAKE COUNTY | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 457 | ||||||||
| Address2: | |||||||||
| City: | WHEELING | ||||||||
| State: | IL | ||||||||
| PostalCode: | 600900457 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8475778811 | ||||||||
| FaxNumber: | 8475779515 | ||||||||
| Practice Location | |||||||||
| Address1: | 400 N NORTHWEST HWY | ||||||||
| Address2: | |||||||||
| City: | BARRINGTON | ||||||||
| State: | IL | ||||||||
| PostalCode: | 600103389 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8473043605 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/02/2006 | ||||||||
| LastUpdateDate: | 09/22/2011 | ||||||||
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| AuthorizedOfficialLastName: | ARIE | ||||||||
| AuthorizedOfficialFirstName: | JAMES | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | CHIEF | ||||||||
| AuthorizedOfficialTelephone: | 8473043605 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 3416L0300X | 98181 | IL | Y | Transportation Services | Ambulance | Land Transport |
ID Information
| ID | Type | State | Issuer | Description | 0208254 | 01 | IL | DEPT OF LABOR OWCP | OTHER | 1670673 | 01 | IL | BLUE CROSS BLUE SHIELD | OTHER | 490014664 | 01 | IL | MEDICARE RAILROAD | OTHER |