City of Lasalle

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

022482 Issued in IL

Legal business name

CITY OF LASALLE

Practice address

745 2ND St
La Salle, IL 61301-2501

Phone

(815) 223-4579

Fax

(815) 223-0857

NPI assigned

Nov 23, 2010

Last updated

Dec 9, 2010By 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. Andrew Antone Bacidore, EMT-BASIC

Title

Fire Chief

Phone

(815) 223-0834

Specialties & licenses 1

Addresses

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": "1290470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291852800000",
    "number": "1346542339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "745 2ND ST",
            "city": "LA SALLE",
            "state": "IL",
            "postal_code": "613012501",
            "telephone_number": "815-223-4579",
            "fax_number": "815-223-0857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "745 2ND ST",
            "city": "LA SALLE",
            "state": "IL",
            "postal_code": "613012501",
            "telephone_number": "815-223-4579",
            "fax_number": "815-223-0857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF LASALLE",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-23",
        "last_updated": "2010-12-09",
        "status": "A",
        "authorized_official_last_name": "BACIDORE",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "ANTONE",
        "authorized_official_title_or_position": "FIRE CHIEF",
        "authorized_official_telephone_number": "815-223-0834",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "EMT-BASIC"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "IL",
            "license": "022482",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth C Campbell, LSW
• Bree N Carlson, MS. CF-SLP
• David Carr
• Stephanie Cartolano, LCPC
• Catholic Charities of the Diocese of Peoria
• Kelley B Conley, MSW
• Cornerstone Counseling
• Maryfrances Crist, APN
• Elizabeth M Davis, LCSW
• John James Derango, DDS

• Land Ambulance in La Salle, IL
• Providers in La Salle, IL by specialty
• Land Ambulance in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2010; 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.