Bourbonnais Fire District

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

77816 Issued in IL

Legal business name

BOURBONNAIS FIRE DISTRICT

Practice address

1080 Armour Rd
Bourbonnais, IL 60914-2102

Phone

(815) 935-9670

Fax

(815) 935-9675

NPI assigned

Jun 4, 2006

Last updated

May 26, 2009By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ed St Louis

Title

Chief

Phone

(815) 935-9670

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Bourbonnais Fire Department Other name

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1243296000000",
    "number": "1013955426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 457",
            "city": "WHEELING",
            "state": "IL",
            "postal_code": "600900457",
            "telephone_number": "847-577-8811",
            "fax_number": "847-577-9515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1080 ARMOUR RD",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "609142102",
            "telephone_number": "815-935-9670",
            "fax_number": "815-935-9675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOURBONNAIS FIRE DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-04",
        "last_updated": "2009-05-26",
        "status": "A",
        "authorized_official_last_name": "ST LOUIS",
        "authorized_official_first_name": "ED",
        "authorized_official_title_or_position": "CHIEF",
        "authorized_official_telephone_number": "815-935-9670"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "IL",
            "license": "77816",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "590014460",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DOL OWCP",
            "identifier": "611645300",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "4630164",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bourbonnais Fire Department",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Kyle Boudreau, P.T.
• Teri Boudreau, LCPC
• Sihem Boulahbal
• Bourbonnais Chiropractic LTD
• Bourbonnais Elementary District 53
• Bourbonnais Sleep Solutions LLC
• Bourbonnais Sleep Solutions LLC (Bourbonnais Sleep Solutions)
• Bourbonnais Terrace Operator LLC
• Kathryn Bozinovich, PT
• Bradley Dental, LLC

• Land Ambulance in Bourbonnais, IL
• Providers in Bourbonnais, IL by specialty
• Land Ambulance in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.