Minooka Fire Protection District
Organization Active NPI Land Ambulance · Minooka, IL
NPI 1073554341 · NPPES record last updated Apr 20, 2008
Key facts
- NPI
- 1073554341
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Land Ambulance 3416L0300X
- License
- 7117 (IL)
- Legal business name
- MINOOKA FIRE PROTECTION DISTRICT
- Practice address
- 413 W Mondamin
Minooka, IL 60447 - Phone
- (815) 467-5637
- Fax
- (847) 577-7967
- NPI assigned
- Jun 9, 2006
- Organization subpart
- No
Authorized official
- Name
- Al Yancy
- Title
- Fire Chief
- Phone
- (815) 467-5637
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120307000871 | IL | Part B Supplier - Ambulance Service Supplier | 6103085329 | Practice locations: Channahon, IL; Minooka, IL |
National Provider Directory
Locations
413 W Mondamin St
Minooka, IL 60447
Phone (815) 467-5637
7901 E Minooka Rd
Minooka, IL 60447
Phone (815) 467-5637
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | 7117 | IL | Yes |
Addresses
Primary practice location
413 W Mondamin
Minooka, IL 60447
Mailing address
PO Box 736
Minooka, IL 60447-0736
Phone (815) 467-5637
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3222002 | Other | IL | BCBS |
Other providers in Minooka, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 20, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.