Healthcare Provider Details

I. General information

NPI: 1295774651
Provider Name (Legal Business Name): MONTGOMERY & COUNTRYSIDE FIRE PROTECTION DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2006
Last Update Date: 10/03/2025
Certification Date: 10/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

198 S RAILROAD ST
MONTGOMERY IL
60538-1420
US

IV. Provider business mailing address

PO BOX 457
WHEELING IL
60090-0457
US

V. Phone/Fax

Practice location:
  • Phone: 630-897-0622
  • Fax: 630-897-3954
Mailing address:
  • Phone: 847-577-8811
  • Fax: 336-510-5893

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number7241
License Number StateIL

VIII. Authorized Official

Name: THOMAS MEYERS
Title or Position: FIRE CHIEF
Credential:
Phone: 630-897-0622