# CRESCENT-IROQUOIS EMS & AMBULANCE

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1346475092
- **Authorized official:** TIM MCCLAIN (CHIEF)
- **Authorized official phone:** (815) 671-9849

## Contact information

- **Practice address:** 104 N MAPLE ST, CRESCENT CITY, IL 60928-8137
- **Practice address phone:** (815) 671-9849
- **Practice address fax:** (815) 683-2035
- **Mailing address:** PO BOX 457, WHEELING, IL 60090-0457
- **Mailing address phone:** (847) 577-8811
- **Mailing address fax:** (847) 577-3518

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | 6773 | IL | Yes |

## Other

- **Enumeration date:** 05/26/2009
- **Last updated:** 03/07/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 614677500 | DEPARTMENT OF LABOR | IL |