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General NPI Number Information
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NPI Number | 1366199044
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Entity Type | Organization
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Legal Business Name | CITY OF STREATOR ILLINOIS
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Dates
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Enumeration Date | 03/03/2022
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Last Update Date | 09/27/2022
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Provider Practice Location Address
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Address Line | 108 N WASSON ST
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City | STREATOR
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State | IL
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Zip | 61364-4011
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Country | US
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Telephone | 815-672-2266
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Fax |
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Provider Business Mailing Address
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Address Line | 204 S BLOOMINGTON ST
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City | STREATOR
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State | IL
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Zip | 61364-2996
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Country | US
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Telephone | 815-672-2517
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Fax |
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Authorized Official
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Title or Position | FIRE CHIEF
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Name | MR. GARY G BIRD
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Credential |
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Telephone | 815-672-2266
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number |
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License Number State |
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