MEDICARE: SHERRARD 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	341600000X	Ambulance	000002548	IL

General Provider Information

NPI Number	:	1730257114
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SHERRARD FIRE PROTECTION DISTRICT

Provider Business Mailing Address
First Line	:	101 EAST 1ST STREET
Second Line	:
City	:	SHERRARD
State	:	IL
Zip	:	61281
Country	:	US
Telephone Number	:	309-526-3395
Fax Number	:	309-526-8995

Provider Business Practice Location Address
First Line	:	101 EAST 1ST STREET
Second Line	:
City	:	SHERRARD
State	:	IL
Zip	:	61281
Country	:	US
Telephone Number	:	309-526-3395
Fax Number	:	309-526-8995

Authorized Official
Title or Position	:	ACCT MANAGER
Name	:	MRS. SUSAN J MOEN
Credential	:
Telephone Number	:	309-526-3395

Provider Enumeration Date	:	12/01/2006
Last Update Date	:	09/16/2008

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Directions to “SHERRARD FIRE PROTECTION DISTRICT ” Practice Location

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