Healthcare Provider Details

I. General information

NPI: 1982633541
Provider Name (Legal Business Name): COUNTY OF MENARD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/03/2006
Last Update Date: 01/02/2025
Certification Date: 01/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19072 STATE HIGHWAY 123
PETERSBURG IL
62675-7570
US

IV. Provider business mailing address

19072 STATE HIGHWAY 123
PETERSBURG IL
62675-7570
US

V. Phone/Fax

Practice location:
  • Phone: 217-632-7700
  • Fax: 217-632-7081
Mailing address:
  • Phone: 217-632-7000
  • Fax: 217-632-7081

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number3 3431
License Number StateIL

VIII. Authorized Official

Name: MR. JONATHON K HUSS
Title or Position: EMS CHIEF/ADMINISTRATOR
Credential: PARAMEDIC
Phone: 217-632-7700