# CITY OF MINONK OF WOODFORD COUNTY

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

## Provider details

- **NPI number:** 1295852515
- **Authorized official:** MS. DEBORAH J STEWART (EMS COORDINATOR)
- **Authorized official phone:** (309) 432-2730

## Contact information

- **Practice address:** 636 JEFFERSON ST, MINONK, IL 61760-1243
- **Practice address phone:** (309) 432-2730
- **Practice address fax:** (309) 432-3547
- **Mailing address:** 670 N CHESTNUT ST, MINONK, IL 61760-1272
- **Mailing address phone:** (309) 432-2558
- **Mailing address fax:** (309) 432-3547

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | 22501 | IL | Yes |

## Other

- **Enumeration date:** 03/23/2007
- **Last updated:** 07/30/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0010215109 | BLUE CROSS | IL |
| 01 | — | 590007853 | RAILROAD MEDICARE | IL |