Provider Demographics
NPI:1447269832
Name:WOODSTOCK FIRE/RESCUE DISTRICT
Entity type:Organization
Organization Name:WOODSTOCK FIRE/RESCUE DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:HILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:815-338-2621
Mailing Address - Street 1:395 WEST LAKE STREET
Mailing Address - Street 2:ATTN: KIMBERLY FULLER
Mailing Address - City:ELMHURST
Mailing Address - State:IL
Mailing Address - Zip Code:60126-1508
Mailing Address - Country:US
Mailing Address - Phone:630-903-2372
Mailing Address - Fax:630-903-2830
Practice Address - Street 1:435 E JUDD ST
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:IL
Practice Address - Zip Code:60098-3419
Practice Address - Country:US
Practice Address - Phone:815-338-2621
Practice Address - Fax:815-334-2010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-05
Last Update Date:2020-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL7 149 0146L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, ParamedicGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL05620987OtherBCBS OF ILL
IL05620987OtherBCBS OF ILL
IL=========001Medicaid
IL=========OtherTRICARE