Mazon Verona Kinsman Rescue Squad District

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

MAZON VERONA KINSMAN RESCUE SQUAD DISTRICT

Practice address

604 Front St
Mazon, IL 60444000

Phone

(815) 448-2134

Fax

(815) 448-2302

NPI assigned

Jul 10, 2017

Last updated

Jul 10, 2017By 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

Jeff Marques

Title

Board President

Phone

(815) 228-2488

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

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

{
    "created_epoch": "1499644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1499644800000",
    "number": "1083136261",
    "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": "800-244-2345",
            "fax_number": "800-329-5274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "604 FRONT ST",
            "city": "MAZON",
            "state": "IL",
            "postal_code": "60444000",
            "telephone_number": "815-448-2134",
            "fax_number": "815-448-2302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAZON VERONA KINSMAN RESCUE SQUAD DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-10",
        "last_updated": "2017-07-10",
        "status": "A",
        "authorized_official_last_name": "MARQUES",
        "authorized_official_first_name": "JEFF",
        "authorized_official_title_or_position": "BOARD PRESIDENT",
        "authorized_official_telephone_number": "815-228-2488"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charles D Comfort, MD
• Grundy Eunoia Wellness Center NFP
• Jason Hamrick, DC
• Adam Kotowski, LSW, MSW, MBA
• Mazon-Verona-Kinsman Elem SD 2C
• MVK Ambulance Service
• Arthur George Wargo
• Craig M Warner, LCSW

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.