Dale Township Fire Protection District

Organization Active NPI Land Ambulance · Shirley, IL

NPI 1114197332 · NPPES record last updated Jun 11, 2025

Key facts

NPI
1114197332
Entity type
Organization (NPI type 2)
Primary specialty
Land Ambulance 3416L0300X
License
02 2563 (IL)
Legal business name
DALE TOWNSHIP FIRE PROTECTION DISTRICT
Practice address
10605 Quinn St
Shirley, IL 61772
Phone
(309) 379-2600
Fax
(309) 682-5327
NPI assigned
Mar 4, 2008
Organization subpart
No

Authorized official

Name
Ryan Gibson
Title
Fire Chief
Phone
(309) 379-2600

Medicare participation

Medicare fee-for-service enrollment
Enrolled in IL

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20080815000359 IL Part B Supplier - Ambulance Service Supplier 9032284609 Practice locations: Shirley, IL

National Provider Directory

Locations

8051 E 1100 North Rd
Bloomington, IL 61705
Phone (309) 379-2600

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X 02 2563 IL Yes

Addresses

Primary practice location

10605 Quinn St
Shirley, IL 61772

Mailing address

PO Box 547
Wheeling, IL 60090-0547
Phone (772) 001-1918

Sources for this page

Verify at the official NPI Registry.