Forreston Fire Protection District

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

1369688 Issued in IL

Legal business name

FORRESTON FIRE PROTECTION DISTRICT

Practice address

301 E. Main Street
Forreston, IL 61030-0212

Phone

(815) 938-2345

NPI assigned

Mar 29, 2007

Organization subpart

No

Name

Mr. Jack Royce Daws

Title

President of Board

Phone

(815) 262-3531

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 18, 2012.

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339977600000",
    "number": "1992824924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. 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": "301 E. MAIN STREET",
            "city": "FORRESTON",
            "state": "IL",
            "postal_code": "610300212",
            "telephone_number": "815-938-2345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORRESTON FIRE PROTECTION DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-29",
        "last_updated": "2012-06-18",
        "status": "A",
        "authorized_official_last_name": "DAWS",
        "authorized_official_first_name": "JACK",
        "authorized_official_middle_name": "ROYCE",
        "authorized_official_title_or_position": "PRESIDENT OF BOARD",
        "authorized_official_telephone_number": "815-262-3531",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "IL",
            "license": "1369688",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF IL PROVIDER",
            "identifier": "07132001",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Estella Allen
• Jennifer L Anderson, DDS
• Paige Marie Chamberlin, MSW
• Forreston Dental
• Forrestville Valley U S D 221
• Freeport Regional Health Care Foundation
• Katherine Kalina, LCSW
• April Lynn Moore, MD
• Keith R. Ruter, D.D.S.

• All providers in Forreston, IL
• Land Ambulance in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 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.