MEDICARE: MANHATTAN FIRE PROTECTION DISTRICT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3416L0300X	Land Ambulance	7710702	IL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	590005802	OTHER	IL	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	099-32093	OTHER	IL	BCBS

General Provider Information

NPI Number	:	1194758706
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MANHATTAN FIRE PROTECTION DISTRICT

Provider Business Mailing Address
First Line	:	395 W LAKE ST
Second Line	:
City	:	ELMHURST
State	:	IL
Zip	:	60126-1508
Country	:	US
Telephone Number	:	630-903-2372
Fax Number	:	630-903-2830

Provider Business Practice Location Address
First Line	:	100 PARK RD
Second Line	:
City	:	MANHATTAN
State	:	IL
Zip	:	60442
Country	:	US
Telephone Number	:	815-478-3197
Fax Number	:	815-478-9880

Authorized Official
Title or Position	:	FIRE CHIEF
Name	:	STEVE MALONE
Credential	:
Telephone Number	:	815-478-3197

Provider Enumeration Date	:	07/08/2006
Last Update Date	:	04/13/2020

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Directions to “MANHATTAN FIRE PROTECTION DISTRICT ” Practice Location

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