| Organization Name: | VILLAGE OF PEORIA HEIGHTS |
| NPI Number: | 1427186584 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JAMES MAROTTA (AMBULANCE ADMINISTRATOR) |
| Mailing Address: | 4901 N Prospect Rd Peoria Heights |
| State: | IL US |
| Postal Code: | 616165397 |
| Phone Number: | 3096862370 |
| Fax Number: | 3096823089 |
| NPI Enumeration Date: | 03/01/2007 |
| NPI Last Update Date: | 04/23/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 3416L0300X |
| License Number: | 22572 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Transportation Services |
| Taxonomy Classification: | Ambulance |
| Taxonomy Specialization: | Land Transport |
| Taxonomy Definition: | |