Healthcare Provider Details

I. General information

NPI: 1225043714
Provider Name (Legal Business Name): ELK GROVE RURAL FIRE PROTECTION DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2006
Last Update Date: 01/30/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1415 E ALGONQUIN RD
ARLINGTON HEIGHTS IL
60005-4715
US

IV. Provider business mailing address

395 WEST LAKE STREET
ELMHURST IL
60126-1508
US

V. Phone/Fax

Practice location:
  • Phone: 847-364-4236
  • Fax: 847-364-9746
Mailing address:
  • Phone: 630-903-2372
  • Fax: 630-903-2830

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number98290
License Number StateIL

VIII. Authorized Official

Name: MICHAEL NELSON
Title or Position: FIRE CHIEF
Credential:
Phone: 847-364-4236