Earlville Com Fire Pro Dist

Primary specialty

AmbulanceTaxonomy code 341600000X

License

1 2554 Issued in IL

Legal business name

EARLVILLE COM FIRE PRO DIST

Practice address

99 N. East St
Earlville, IL 60518-8232

Phone

(815) 246-7095

Fax

(815) 246-7095

NPI assigned

Aug 28, 2006

Last updated

May 26, 2016By 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

Brent Hansen

Title

Ambulance Director

Phone

(815) 970-4921

Specialties & licenses 1

Addresses

Other identifiers 3

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": "1156723200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1464220800000",
    "number": "1124136320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 260",
            "city": "MENDOTA",
            "state": "IL",
            "postal_code": "613420260",
            "telephone_number": "815-539-2468",
            "fax_number": "815-539-6427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 N. EAST ST",
            "city": "EARLVILLE",
            "state": "IL",
            "postal_code": "605188232",
            "telephone_number": "815-246-7095",
            "fax_number": "815-246-7095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EARLVILLE COM FIRE PRO DIST",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-28",
        "last_updated": "2016-05-26",
        "status": "A",
        "authorized_official_last_name": "HANSEN",
        "authorized_official_first_name": "BRENT",
        "authorized_official_title_or_position": "AMBULANCE DIRECTOR",
        "authorized_official_telephone_number": "815-970-4921"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "IL",
            "license": "1 2554",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0005032023",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "362038712001",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "590000937",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Aughenbaugh Family Chiropractic Clinic Inc
• Scott D Aughenbaugh, DC
• Kwang P Chung, MD
• Earlville Comm Unit SCH Dist 9
• Hand Therapy of Lasalle County, Inc.
• Kathrine Hoffower, LCPC
• Kwang P Chung MD SC
• Mindful Matters Therapy LLC

• Ambulance in Earlville, IL
• Providers in Earlville, IL by specialty
• Ambulance in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2016; 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.