MEDICARE: BEECHER 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	77930	IL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	590014456	OTHER	IL	MEDICARE RAILROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	9919313	OTHER	IL	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1609819697
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BEECHER FIRE PROTECTION DISTRICT

Provider Business Mailing Address
First Line	:	PO BOX 1053
Second Line	:
City	:	MOKENA
State	:	IL
Zip	:	60448-2052
Country	:	US
Telephone Number	:	708-478-5694
Fax Number	:

Provider Business Practice Location Address
First Line	:	711 PENFIELD STREET
Second Line	:
City	:	BEECHER
State	:	IL
Zip	:	60401
Country	:	US
Telephone Number	:	708-946-6585
Fax Number	:	708-946-3723

Authorized Official
Title or Position	:	CHIEF
Name	:	JOSEPH FALASCHETTI
Credential	:
Telephone Number	:	708-946-6585

Provider Enumeration Date	:	06/14/2006
Last Update Date	:	12/18/2019

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Directions to “BEECHER FIRE PROTECTION DISTRICT ” Practice Location

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