Organization
VILLAGE OF CRETE
Active
Other names
Crete Fire Department
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL WATERMAN (FIRE CHIEF)
(708) 672-5431
Entity
Organization
Contact information
Practice address
524 W EXCHANGE ST, CRETE, IL 60417-2139
(708) 672-5431
(708) 672-3920
Mailing address
PO BOX 1053, MOKENA, IL 60448-2052
(708) 478-5694
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
7314
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
278720500
DOL OWCP
IL
01
—
590001912
RR MEDICARE
IL
01
—
9970504
BCBS
IL
Enumeration date
07/15/2006
Last updated
12/18/2019
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