Organization
TROY FIRE PROTECTION DISTRICT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KENNETH BOTTOMLEY (TRUSTEE)
(815) 725-2149
Entity
Organization
Contact information
Practice address
107 W. JEFFERSON STREET, SHOREWOOD, IL 60404-9399
(815) 725-2149
(815) 725-0772
Mailing address
107 W. JEFFERSON STREET, SHOREWOOD, IL 60404-9399
(815) 725-2149
(815) 725-0772
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
7303
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9932486
BLUE CROSS BLUE SHIELD
IL
Enumeration date
08/14/2006
Last updated
06/21/2018
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