MEDICARE: OAKBROOK TERRACE FIRE PROTECTION DISTRICT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	341600000X	Ambulance
2	3416L0300X	Land Ambulance

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	590008490	OTHER		RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2219419	OTHER	IL	BCBS OF IL

General Provider Information

NPI Number	:	1013914852
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OAKBROOK TERRACE FIRE PROTECTION DISTRICT

Provider Business Mailing Address
First Line	:	PO BOX 3366
Second Line	:
City	:	OAK BROOK
State	:	IL
Zip	:	60522-3366
Country	:	US
Telephone Number	:	630-275-4050
Fax Number	:	630-275-4057

Provider Business Practice Location Address
First Line	:	17W400 BUTTERFIELD RD
Second Line	:
City	:	OAKBROOK TERRACE
State	:	IL
Zip	:	60181-4045
Country	:	US
Telephone Number	:	630-834-2759
Fax Number	:	630-834-1085

Authorized Official
Title or Position	:	FINANCE DIRECTOR
Name	:	MR. GREGORY J. SEBESTA
Credential	:
Telephone Number	:	630-834-2759

Provider Enumeration Date	:	07/07/2005
Last Update Date	:	04/13/2020

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Directions to “OAKBROOK TERRACE FIRE PROTECTION DISTRICT ” Practice Location

Language	Start Address	Practice Location

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