MEDICARE: MONEE 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	3416L0300X	Land Ambulance	7909	IL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00232073	OTHER	IL	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	9932346	OTHER	IL	BCBS

General Provider Information

NPI Number	:	1992731756
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MONEE FIRE PROTECTION DISTRICT

Provider Business Mailing Address
First Line	:	PO BOX 457
Second Line	:
City	:	WHEELING
State	:	IL
Zip	:	60090-0457
Country	:	US
Telephone Number	:	847-577-8811
Fax Number	:	847-577-7967

Provider Business Practice Location Address
First Line	:	5500 W MAIN ST
Second Line	:
City	:	MONEE
State	:	IL
Zip	:	60449
Country	:	US
Telephone Number	:	708-235-0472
Fax Number	:	708-235-0471

Authorized Official
Title or Position	:	FIRE CHIEF
Name	:	CARL NEILAND I
Credential	:
Telephone Number	:	708-235-0472

Provider Enumeration Date	:	06/23/2006
Last Update Date	:	04/20/2008

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Directions to “MONEE FIRE PROTECTION DISTRICT ” Practice Location

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