# CITY OF EAST PEORIA

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

## Provider details

- **NPI number:** 1285653485
- **Authorized official:** MICHAEL VAUGHN (FIRE CHIEF)
- **Authorized official phone:** (309) 698-4740

## Contact information

- **Practice address:** 201 W WASHINGTON ST, EAST PEORIA, IL 61611-2416
- **Practice address phone:** (309) 698-4740
- **Practice address fax:** (309) 698-4725
- **Mailing address:** PO BOX 457, WHEELING, IL 60090-0457
- **Mailing address phone:** (847) 577-8811
- **Mailing address fax:** (847) 577-7967

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | 2968 | IL | Yes |

## Other

- **Enumeration date:** 07/19/2006
- **Last updated:** 04/20/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 690333345001 | — | IL |
| 01 | — | 9020610 | BCBS | IL |