Odell Fire Protection District

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

2 2988 Issued in IL

Legal business name

ODELL FIRE PROTECTION DISTRICT

Doing business as

Odell Ambulance Service

Practice address

210 South Front
Odell, IL 60460-0435

Phone

(815) 998-2410

Fax

(815) 998-1326

NPI assigned

Nov 16, 2006

Last updated

Apr 20, 2008By 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

Mr. Brian Mills

Title

EMS Coordinator

Phone

(815) 998-2410

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Odell Ambulance Service Doing business as

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": "1163635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1346313350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 435",
            "address_2": "210 SOUTH FRONT",
            "city": "ODELL",
            "state": "IL",
            "postal_code": "604600435",
            "telephone_number": "815-998-2410",
            "fax_number": "815-998-1326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 SOUTH FRONT",
            "city": "ODELL",
            "state": "IL",
            "postal_code": "604600435",
            "telephone_number": "815-998-2410",
            "fax_number": "815-998-1326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ODELL FIRE PROTECTION DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-16",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "MILLS",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "EMS COORDINATOR",
        "authorized_official_telephone_number": "815-998-2410",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "IL",
            "license": "2 2988",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE  CROSS BLUE SHIELD",
            "identifier": "05332021",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Odell Ambulance Service",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Odell Grade School Dist 435
• Renee Ann Owen

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; 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.