MAPLE PARK AND COUNTRYSIDE FIRE; NPI #1386752525

Contact Information

MAPLE PARK AND COUNTRYSIDE FIRE

305 S. COUNTYLINE ROAD
MAPLE PARK, IL 60151

Phone: 815-827-3500
Fax: 815-827-3746
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Ambulance	341600000X	59	Ambulance Service Provider

Indicates primary specialty

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NPI Profile & details for MAPLE PARK AND COUNTRYSIDE FIRE

NPI Number 1386752525

LBN Legal business name MAPLE PARK AND COUNTRYSIDE FIRE

Authorized official KEVIN PETERSON - (FIRE CHIEF)

Entity Organization

Organization subpart ¹ No

Enumeration date 08/28/2006

Last updated 04/20/2008 - About 18 years ago

Identifiers

IL	License #	1 1018
IL	Other	05032052	BLUE CROSS BLUE SHIELD
IL	Other	5032052	RAILROAD MEDICARE

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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