Healthcare Provider Details
I. General information
NPI: 1578587838
Provider Name (Legal Business Name): HEBRON ALDEN GREENWOOD FIRE PROTECTION DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/27/2006
Last Update Date: 04/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
12302 ILLINOIS ROUTE 173 BOX 345
HEBRON IL
60034
US
IV. Provider business mailing address
PO BOX 457
WHEELING IL
60090-0457
US
V. Phone/Fax
- Phone: 815-648-2218
- Fax: 815-648-2218
- Phone: 847-577-8811
- Fax: 847-577-7967
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3416L0300X |
| Taxonomy | Land Ambulance |
| License Number | 7973 |
| License Number State | IL |
VIII. Authorized Official
Name:
DENNIS
MCFARLIN
Title or Position: FIRE CHIEF
Credential:
Phone: 815-648-2218