Healthcare Provider Details

I. General information

NPI: 1346421492
Provider Name (Legal Business Name): DOWNS COMMUNITY FIRE PROTECTION DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/16/2007
Last Update Date: 10/26/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 SEMINARY ST
DOWNS IL
61736
US

IV. Provider business mailing address

102 W MAIN ST
DOWNS IL
61736-9600
US

V. Phone/Fax

Practice location:
  • Phone: 309-378-2021
  • Fax: 309-378-2054
Mailing address:
  • Phone: 309-378-2021
  • Fax: 309-378-2054

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number25071
License Number StateIL

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MR. MICHAEL SCOTT BETTISCH
Title or Position: EMT COORDINATOR
Credential: EMT-B
Phone: 309-378-4020