# SHABBONA COMM FIRE DISTRICT

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

## Provider details

- **NPI number:** 1932132008
- **Authorized official:** FRANK OTTENGHEIME (FIRE CHIEF)
- **Authorized official phone:** (815) 824-2115

## Contact information

- **Practice address:** 103 E NAVAHO AVE, SHABBONA, IL 60550-5147
- **Practice address phone:** (815) 824-2115
- **Practice address fax:** (815) 824-2938
- **Mailing address:** PO BOX 260, MENDOTA, IL 61342-0260
- **Mailing address phone:** (815) 539-2468
- **Mailing address fax:** (815) 539-6427

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | 1408 | IL | Yes |

## Other

- **Enumeration date:** 07/09/2006
- **Last updated:** 07/18/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1921562 | BCBS | IL |
| 01 | — | 590012025 | RR MEDICARE | IL |