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General NPI Number Information
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NPI Number | 1225174733
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Entity Type | Organization
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Legal Business Name | OTTO TOWNSHIP FIRE PROTECTION DIST
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Dates
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Enumeration Date | 01/30/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 101 S CHESTNUT STREET
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City | CHEBANSE
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State | IL
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Zip | 60922
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Country | US
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Telephone | 815-697-2422
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Fax | 815-697-3313
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Provider Business Mailing Address
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Address Line | PO BOX 456 101 S CHESTNUT STREET
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City | CHEBANSE
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State | IL
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Zip | 60922
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Country | US
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Telephone | 815-697-2422
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Fax | 815-697-3313
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Authorized Official
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Title or Position | EMS DIRECTOR
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Name | MRS. MARTHA KEMNETZ
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Credential | PARAMEDIC FIREFIGHTE
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Telephone | 815-697-2422
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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License Number | 781802
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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License Number | 781801
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License Number State | IL
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