Organization Active NPI

Limestone Township Fire Protection District

  • Land Ambulance
  • Kankakee, IL
National Provider Identifier
1760497473
Registry record updated Sep 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
License
7247 Issued in IL
Legal business name
LIMESTONE TOWNSHIP FIRE PROTECTION DISTRICT
Practice address
4948 W State Route 17
Kankakee, IL 60901-8082
Phone
(815) 932-4664
Fax
(815) 932-9792
NPI assigned
Jul 30, 2006
Last updated
Sep 28, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jeff Brosseau
Title
Fire Chief
Phone
(815) 932-4664

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X 7247 IL Primary

Addresses

Primary practice location

4948 W State Route 17
Kankakee, IL 60901-8082

Mailing address

PO Box 457
Wheeling, IL 60090-0457
Phone (847) 577-8811

Other identifiers 2

IdentifierTypeStateIssuer
4630368OtherILBCBS
590008305OtherILRR MEDICARE

Other names 1

  • Limestone Fire Department Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111119000078 IL Part B Supplier - Ambulance Service Supplier 4688848112 Practice locations: Kankakee, IL

National Provider Directory

National Provider Directory

Locations

4312 W Route 17
Kankakee, IL 60901
Phone (815) 932-4664

4948 W State Route 17
Kankakee, IL 60901
Phone (815) 932-4664

NPI Registry JSON

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

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317168000000",
    "number": "1760497473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 457",
            "city": "WHEELING",
            "state": "IL",
            "postal_code": "600900457",
            "telephone_number": "847-577-8811",
            "fax_number": "847-577-7967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4948 W STATE ROUTE 17",
            "city": "KANKAKEE",
            "state": "IL",
            "postal_code": "609018082",
            "telephone_number": "815-932-4664",
            "fax_number": "815-932-9792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIMESTONE TOWNSHIP FIRE PROTECTION DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-30",
        "last_updated": "2011-09-28",
        "status": "A",
        "authorized_official_last_name": "BROSSEAU",
        "authorized_official_first_name": "JEFF",
        "authorized_official_title_or_position": "FIRE CHIEF",
        "authorized_official_telephone_number": "815-932-4664"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "IL",
            "license": "7247",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "4630368",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "590008305",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Limestone Fire Department",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Kankakee, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2011; 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.