MEDICARE: ITASCA FIRE PROTECTION DISTRICT NO 1

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	97104	IL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	590013623	OTHER	IL	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	022-20910	OTHER	IL	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1235188152
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ITASCA FIRE PROTECTION DISTRICT NO 1

Provider Business Mailing Address
First Line	:	PO BOX 1368
Second Line	:
City	:	ELMHURST
State	:	IL
Zip	:	60126-8368
Country	:	US
Telephone Number	:	630-530-2988
Fax Number	:	630-832-9750

Provider Business Practice Location Address
First Line	:	520 W IRVING PARK RD
Second Line	:
City	:	ITASCA
State	:	IL
Zip	:	60143-2018
Country	:	US
Telephone Number	:	630-773-1223
Fax Number	:	630-773-3381

Authorized Official
Title or Position	:	FIRE CHIEF
Name	:	JOHN W SCHNEIDWIND
Credential	:
Telephone Number	:	630-773-1240

Provider Enumeration Date	:	05/08/2006
Last Update Date	:	09/08/2025

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Directions to “ITASCA FIRE PROTECTION DISTRICT NO 1 ” Practice Location

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