# MAZON VERONA KINSMAN RESCUE SQUAD DISTRICT

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083136261
- **Authorized official:** JEFF MARQUES (BOARD PRESIDENT)
- **Authorized official phone:** (815) 228-2488

## Contact information

- **Practice address:** 604 FRONT ST, MAZON, IL 60444-000
- **Practice address phone:** (815) 448-2134
- **Practice address fax:** (815) 448-2302
- **Mailing address:** PO BOX 457, WHEELING, IL 60090-0457
- **Mailing address phone:** (800) 244-2345
- **Mailing address fax:** (800) 329-5274

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | — | NULL | Yes |

## Other

- **Enumeration date:** 07/10/2017
- **Last updated:** 07/10/2017