| Organization Name: | VILLAGE OF BOLINGBROOK ILLINOIS |
| NPI Number: | 1104811967 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | TRINIDAD D GARZA (DEPUTY FIRE CHIEF) |
| Mailing Address: | 375 W Briarcliff Rd Bolingbrook |
| State: | IL US |
| Postal Code: | 604403825 |
| Phone Number: | 6302268540 |
| Fax Number: | 6307594016 |
| NPI Enumeration Date: | 09/16/2005 |
| NPI Last Update Date: | 06/02/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 3416A0800X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Transportation Services |
| Taxonomy Classification: | Ambulance |
| Taxonomy Specialization: | Air Transport |
| Taxonomy Definition: | |