City of Minonk of Woodford County

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

22501 Issued in IL

Legal business name

CITY OF MINONK OF WOODFORD COUNTY

Practice address

636 Jefferson St
Minonk, IL 61760-1243

Phone

(309) 432-2730

Fax

(309) 432-3547

NPI assigned

Mar 23, 2007

Last updated

Jul 30, 2012By 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

Ms. Deborah J Stewart

Title

EMS Coordinator

Phone

(309) 432-2730

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

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

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1343606400000",
    "number": "1295852515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "670 N CHESTNUT ST",
            "city": "MINONK",
            "state": "IL",
            "postal_code": "617601272",
            "telephone_number": "309-432-2558",
            "fax_number": "309-432-3547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "636 JEFFERSON ST",
            "city": "MINONK",
            "state": "IL",
            "postal_code": "617601243",
            "telephone_number": "309-432-2730",
            "fax_number": "309-432-3547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF MINONK OF WOODFORD COUNTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-23",
        "last_updated": "2012-07-30",
        "status": "A",
        "authorized_official_last_name": "STEWART",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "EMS COORDINATOR",
        "authorized_official_telephone_number": "309-432-2730",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "IL",
            "license": "22501",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "590007853",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "0010215109",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Russa Aussieker, PTA
• Sharon A Austin, CNP
• Jordan Marie Baker, COTA/L
• Stephanie M Bressner, RPH
• Champion Fitness, Inc
• Jamie Conover
• Crowley Physical Therapy LLC (Crowley Physical Therapy)
• Jonathon C Crowley, MPT, MTC
• Fieldcrest Cusd 6
• Sonja Marie Frei, L.M.T.

• Land Ambulance in Minonk, IL
• Providers in Minonk, 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 30, 2012; 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.